Differences regarding symptoms of SARS-CoV-2-Infection in pediatric and adolescent athletes in comparison to adult athletes

Background

Most children are afflicted by a mild SARS-CoV-2-infection course in comparison to adults. However, data about differences between the experienced symptoms of pediatric/adolescent in comparison to adult athletes are sparse.

Methods

Competitive athletes of any age, who presented for preparticipation screening 04/2020–10/2021 with confirmed SARS-CoV-2-infection were included in this study, stratified for pediatric/adolescent (≤18years) or adult age (>18years) and both age-groups were compared regarding symptoms.

Results

Overall, 157 athletes with former SARS-CoV-2-infection (mean age 22.0 [18.0/27.0] years; 35.0 % females) were included in our study 04/2020 – 10/2021; among them, 40 (25.5 %) were pediatric/adolescent and 117 (74.5 %) adult athletes.

Pediatric/adolescent athletes had significantly more often an asymptomatic SARS-CoV-2-infection (22.5% vs. 6.0 %, P = 0.003). Symptoms of cold and flu-like symptoms (81.2% vs. 57.5 %, P = 0.003) and neurological symptoms (83.8% vs. 60.0 %, P = 0.002) were more often detected in adult athletes, while respiratory and cardiac symptoms were similar prevalent in both groups.

Age ≤ 18 years was independently associated with higher prevalence of asymptomatic SARS-CoV-2-infection (OR 5.12 [95 %CI 1.71–15.33], P = 0.004), but reduced occurrence of cold and flu-like symptoms (OR 0.27 [95 %CI 0.12–0.62], P = 0.002) and of neurological symptoms (OR 0.29 [95 %CI 0.13–0.67], P = 0.003). The included athletes were very rarely affected by adverse events. Pneumonia was detected in one adult athlete (0.9% vs. 0 %). None of the included athletes were afflicted by myocarditis or other serious adverse events.

Conclusions

Pediatric/adolescent athletes had more often an asymptomatic SARS-CoV-2-infection or were afflicted by only mild symptoms, while adult athletes suffered from larger symptom-burden predominantly driven by neurologic symptoms.