SARS-CoV-2 Positivity in a Combat Sports Bubble.

OBJECTIVE: The objective of this report is to describe a SARS-CoV-2 protocol and subsequent positivity rate for athletes and staff participating in combat sports events. BACKGROUND: Combat sports are among the most challenging to protect against the transmission of communicable diseases. Sports neurologists are often called on to take a leadership role in the safe management of these events. Our team was asked to provide a plan for pre-fight SARS-CoV-2 testing during the recent pandemic. As a result, we were able to successfully host 28 major combat sports events at a single venue with minimal exposure for staff and participants. DESIGN/METHODS: Athletes and staff were tested for the SARS-CoV-2 virus with a PCR method. Samples were obtained via nasal swab upon arrival at the host hotel. All participants were then quarantined until the results were available. Those with negative tests were allowed to resume training in isolated pods. All participants were retested within 72 hours of the event. Those who were positive were quarantined off site for up to 2 weeks. Consultation was provided with an infectious disease specialist via telemedicine. RESULTS: A total of 8,135 tests were performed from July 1, 2020 until April 30, 2021 for the purpose of maintaining a safe venue. A total of 1,649 subjects were tested. There were 42 positive tests that resulted in an overall SARS-CoV-2 positivity rate of 0.516% for these events. CONCLUSIONS: Our sports neurology team was able to design and implement an effective plan to protect combat sports athletes and staff during the SARS-CoV-2 pandemic. This allowed the safe continuation of 28 events. This protocol design can be implemented when dealing with future outbreaks of communicable diseases.

Sports neurology topics in neurologic practice: A survey of AAN members.

We sought to assess neurologists' interest in sports neurology and learn about their experience in treating sports-related neurologic conditions. A survey was sent to a random sample of American Academy of Neurology members. A majority of members (77%) see at least some patients with sports-related neurologic issues. Concussion is the most common sports-related condition neurologists treat. More than half of survey participants (63%) did not receive any formal or informal training in sports neurology. At least two-thirds of respondents think it is very important to address the following issues: developing evidence-based return-to-play guidelines, identifying risk factors for long-term cognitive-behavioral sequelae, and developing objective diagnostic criteria for concussion. Our findings provide an up-to-date view of the subspecialty of sports neurology and identify areas for future research.

Disaster neurology: A new practice opportunity and challenge for the neurologist.

Headlines are filled with stories of the physical disability and loss of life that results from both natural and man-made disasters. The role of a neurologist as part of the response to these tragedies has moved from a supportive role to the front line. Recent earthquakes in Haiti and Japan as well as military conflicts in Iraq and Afghanistan have demonstrated an increased need for nonsurgical neurologic care. Disaster neurology has become attractive to neurologists at many stages of their careers. Employed, academic, and private practice neurologists all have the potential to embrace this opportunity to apply their clinical skills to help others in need of care. Neurologists interested in engaging in disaster relief efforts should have the ability to respond to a situation quickly with the flexibility of devoting several weeks to the response effort.

Sports concussion.

Concussion is an injury to the brain occurring as the result of biomechanical forces, generally characterized by the rapid onset of a constellation of symptoms or cognitive impairment, which is typically self-limited and resolves spontaneously. Concussion as the result of playing sports is particularly common, estimated to occur up to 3.8 million times each year in the United States. Although most concussions can be considered benign, the symptoms are often severe enough to interfere with daily function. A small percentage of concussions can be more serious, resulting in a prolonged symptom course, significant morbidity, or even death. The management of concussion in the athlete presents a unique set of challenges for the clinician, requiring not only a detailed neurologic history and examination, but also careful consideration of an athlete's risk of further injury and possible long-term sequelae.