Evaluating the impact of the COVID-19 pandemic on performance during the 2022 56 km Two Oceans ultra-marathon.

BACKGROUND: The 56km Two Oceans ultra-marathon (TOM), in Cape Town, South Africa, was cancelled in 2020 and 2021 because of the COVID-19 pandemic. Since most other road running events were also cancelled during this period, we hypothesized that most athletes who entered TOM 2022 would be inadequately trained, which would negatively affect performance. However, many world records were broken post-lockdown, and therefore the performance, specifically of the elite athletes, during TOM might actually improve. The aim of this analysis was to evaluate the impact of the COVID-19 pandemic on performance in TOM 2022 compared to the 2018 event. METHODS: Performance data during the two events, as well as the 2021 Cape Town marathon, was extracted from public databases. RESULTS: Fewer athletes entered TOM 2022 (N.=4741) compared to TOM 2018 (N.=11,702), of which more were male (2022: 74.5% vs. 2018: 70.4%, P<0.05) and in the 40+ age-group categories. Compared to 2018 (11.3%), fewer athletes did not finish TOM 2022 (3.1%). Only 10.2% of the finishers completed the 2022 race during the last 15-minutes prior to the cut-off, compared to 18.3% in 2018. There were no differences in the average 2022 finishing time of the subset of 290 athletes whose times were compared to their 2018 performance. There was no difference in the TOM 2022 performance of athletes who had completed the 2021 Cape Town marathon, 6-months earlier, when compared to those who had not entered the marathon. CONCLUSIONS: Although there were fewer entrants, most athletes who entered knew that they were adequately trained to complete TOM 2022, with the top runners breaking course records. There was therefore no impact of the pandemic on performance during TOM 2022.

Potential Long-Term Health Problems Associated with Ultra-Endurance Running: A Narrative Review.

It is well established that physical activity reduces all-cause mortality and can prolong life. Ultra-endurance running (UER) is an extreme sport that is becoming increasingly popular, and comprises running races above marathon distance, exceeding 6 h, and/or running fixed distances on multiple days. Serious acute adverse events are rare, but there is mounting evidence that UER may lead to long-term health problems. The purpose of this review is to present the current state of knowledge regarding the potential long-term health problems derived from UER, specifically potential maladaptation in key organ systems, including cardiovascular, respiratory, musculoskeletal, renal, immunological, gastrointestinal, neurological, and integumentary systems. Special consideration is given to youth, masters, and female athletes, all of whom may be more susceptible to certain long-term health issues. We present directions for future research into the pathophysiological mechanisms that underpin athlete susceptibility to long-term issues. Although all body systems can be affected by UER, one of the clearest effects of endurance exercise is on the cardiovascular system, including right ventricular dysfunction and potential increased risk of arrhythmias and hypertension. There is also evidence that rare cases of acute renal injury in UER could lead to progressive renal scarring and chronic kidney disease. There are limited data specific to female athletes, who may be at greater risk of certain UER-related health issues due to interactions between energy availability and sex-hormone concentrations. Indeed, failure to consider sex differences in the design of female-specific UER training programs may have a negative impact on athlete longevity. It is hoped that this review will inform risk stratification and stimulate further research about UER and the implications for long-term health.

The Impact of the COVID-19 Pandemic on Endurance and Ultra-Endurance Running.

Background and objectives: The COVID-19 outbreak has become a major health and economic crisis. The World Health Organization declared it a pandemic in March 2020, and many sporting events were canceled. Materials and Methods: We examined the effects of the COVID-19 pandemic on endurance and ultra-endurance running (UER) and analyzed finishes and events during the COVID-19 pandemic (observation period March 2020-October 2020) to the same time period pre-COVID-19 outbreak (March 2019-October 2019). Results: Endurance finishes decreased during the pandemic (459,029 to 42,656 (male: 277,493 to 25,582; female 181,536 to 17,074; all p < 0.001). Similarly, the numbers of endurance events decreased (213 vs. 61 events; p < 0.001). Average marathon finishing times decreased during the pandemic in men (5:18:03 ± 0:16:34 vs. 4:43:08 ± 0:25:08 h:min:s (p = 0.006)) and women (5:39:32 ± 0:19:29 vs. 5:14:29 ± 0:26:36 h:min:s (p = 0.02)). In UER, finishes decreased significantly (580,289 to 110,055; p < 0.001) as did events (5839 to 1791; p < 0.001). Popular event locations in United States, France, UK, and Germany decreased significantly (p < 0.05). All distance and time-limited UER events saw significant decreases (p < 0.05). Conclusions: The COVID-19 pandemic has had a significant effect on endurance and UER, and it is unlikely that running activities return to pre-pandemic levels any time soon. Mitigation strategies and safety protocols should be established.