Characteristics and Causes of Sports-Related Sudden Death in the General Population during the COVID-19 Pandemic.

Purpose: COVID-19 is an independent risk factor for cardiovascular disease. The aim of this study is to determine the burden, characteristics, and causes of sudden death in sport (SrSD) before and after the COVID-19 pandemic in the general population.

Methods: Retrospective observational study. Autopsied SrSD studied in Catalonia were consecutively included. Two periods were considered: Before lockdown (January 2019-March 2020) and after lockdown (March 2020-December 2021). Initial care variables and causes of death were collected. Periods were compared, and logistic regression analyses were performed.

Results: A total of 156 SrSD were collected, with no differences in the incidence between the study periods. Of the cases, 98.7% were male, with a mean age of 55.8 years (SD 12.1). Cycling was practised by 40.0%. Coronary artery disease was the leading cause of death, with no difference before and after lockdown. No cases of myocarditis were described. Of the total number of SrSD, 98 (62.8%) received a CPR attempt. After lockdown, the SrSD that occurred in country areas decreased (40.6% vs 24.4 %, p = 0.032), the rate of CPR attempts (54.3% vs 69.8%, p = 0.034) and hands only CPR increased (76.6% vs 57.9%, p = 0.048).

Conclusions: There were no changes in the burden and causes of SrSD before and after the COVID-19 lockdown. Differences were found in the SrSD initial care received due to the change of basic life support recommendations and the sport activity habits.