[Clinical impact of SARS-CoV2 infection in professional footballers of the Tunisian Premier League]. / Impact clinique de l'infection par le SARS-CoV2 chez les footballeurs professionnels de la première ligue Tunisienne.

AIM OF THE STUDY: The aim of our work, developed within the Tunisian Football Federation (TFF), was to study the clinical manifestations and the possible cardiac complications in professional footballers of the first league having contracted an infection by SARS-CoV2. PATIENTS AND METHODS: This is a retrospective, descriptive, and analytical study. Professional Premier League football players who contracted COVID-19 from the onset of the pandemic through June 2021 were included. RESULTS: Among the 1388 players of the Tunisian first professional league, 102 players (7.35%) had COVID-19. Three were excluded for lack of clinical data. The average age of the subjects included was 26 ± 4 years with extremes ranging from 19 to 37 years. The most frequent clinical manifestations were anosmia, agueusia and muscle fatigue. The clinical examination was normal in all the subjects included except for the presence of fever among 37 (37.9%) subjects. All subjects' electrocardiogram did not show any unusual abnormality. As for the imaging data, two players presented a pericardial effusion without signs of severity. In the other players, echocardiography was normal. Cardiac magnetic resonance imaging did not reveal any abnormality. CONCLUSION: The results of our study showed that there was no severe form of COVID-19 among professional soccer players. Larger scale studies integrating other leagues and different sport categories may provide more information on the clinical impact of this disease in high level athletes.

Contribution of bone mineral density in stress fractures of elite athletes.

INTRODUCTION: The stress fracture occurs in a healthy bone with a lack of adaptation to sustained, intensive and repetitive physical activity. However, bone mineral density is strongly correlated with bone strength and fractures may occur more easily on osteoporotic bone. AIM: To evaluate the bone densitometric profile of elite athletes with a history of stress fracture and to determine the interest in preventing this type of fracture. METHODS: cross-sectional study comparing a group of elite athletes to a control group matched by sex, age and sports discipline. Bone mineral density is measured by dual energy x-ray absorptiometry. RESULTS: Our study involved 10 elite athletes with a mean age of 20.3 years and a history of stress fracture, compared to a population of 8 controls practicing the same sport with the same training volume per week. The diagnosis of clinically suspected stress fracture is confirmed in all cases by bone scintigraphy. Osteopenia is diagnosed in one patient while osteoporosis is found in one of the controls. No significant difference was found between the 2 mean bone densities (at the lumbar spine and proximal femur) among the 2 groups. CONCLUSION: bone densitometry does not seem to be, according to our study, a relevant tool in preventing stress fractures in elite athletes.

Assessment of premature ventricular beats in athletes.

INTRODUCTION: Premature ventricular complexes (PVC) are generally considered as a benign electrocardiographic abnormality in the athleticpopulation. However it may be indicative of underlying heart disease which may increase the risk of sudden death. This implies the need forcardiological evaluation before indicating the ability to practice competitive sports. AIM: The aim of this study was to evaluate an athlete population with PVC and establish underlying etiologies in order to take a decisionregarding practicing sports. METHODS: This is a prospective study which included athletes examined in the Tunisian National Centre of Sports Medicine and Sports Science (TNCSM) from January 2013 to June 2015 who presented PVC on an electrocardiogram RESULTS: 5798 athletes were referred to the TNCSM . We identified 42 athletes having PVC with a prevalence of 1.8%. The average age of thestudy population was 21.6 ± 5.99 years. 83% were men. 88% were asymptomatic the electrocardiogram was considered normal in 62% ofthe athletes according to the Seattle criteria, At the Holter monitoring, the average number of PVC was 920 PVC / 24 hours. Thirteen athleteshad doublets and 11 had triplets. One patient had polymorphic PVC and an R/T phenomenon. The transthoracic echocardiography (TTE) wasnormal in 71 % of cases. Three athletes had hypertrophic cardiomyopathy (HCM). All patients underwent a stress test. The PVC disappearedin 12% of athletes. MRI was performed in 10 athletes confirming the three cases of HCM and revealing a case of arrhythmogenic rightventricular dysplasia and a case of compression of the right ventricle by pectusexacavatum. CONCLUSION: After this assessment, five athletes were not allowed to practice sport. This study shows the necessity of a thorough cardiological assessment of athletes with ventricular arrhythmia in order to detect underlying heart disease and prevent sudden death in this young apparentlyhealthy population.