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COVID and Sports Concussions - 81alum - 04-05-2023

I just received a report from an Associate Athletics Director at my institution that concussions in football increased more than 200% last year.  Apparently this is something that is happening at many universities.  Early studies, I was told, indicate that athletes who have had COVID are up to three times more vulnerable to concussions, at least over the next 60 days.  The COVID to concussion connection was not known before January.

This is very preliminary information but I would guess that we will hear a lot more about it as more studies are done.

It raises lots of questions.  1) Should athletes be held out of practice and gameplay for 60 days after having COVID, to reduce their risks?  2) Should athletes be kept on COVID boosters even after vaccine mandates expire for everyone else, to reduce their concussion risk?

https://bjsm.bmj.com/content/early/2023/02/07/bjsports-2022-106436
https://www.sportsmedres.org/tested-positive-for-covid-be-careful-out-there/


RE: COVID and Sports Concussions - Mick - 04-05-2023

I think there's a lot we don't know about the aftermath of COVID for those who've been infected.

Early last year, I had a sudden and total hearing loss in my right ear, about 90 days after I had the Omicron variant. It wasn't gradual, I woke up one day and it was gone. I met with several audiologists and an ENT specialist at Sutter Health. The audiologist asked if I'd experienced a sudden very loud noise (no), a blow to the head (no), blood clots (no). She then asked if I'd been infected with COVID. She said that ever since the Omicron variant, she'd seen a marked increase in people suffering from SSNHL (Sudden Sensorineural Hearing Loss). There was no proof, not at the time, but the theory was that the nerves in the ear responsible for hearing are susceptible to COVID.  

Here's a few links:

COVID-19 could lead to long-term hearing issues according to studies
Sensorineural Hearing Loss Post-COVID-19 Infection: An Update - PMC (nih.gov)
COVID-19 and Hearing Loss | Ear, Nose and Throat Services

I had four steroids shots behind my eardrum and a regimen of antivirals.  Got back about 35% of my hearing.


RE: COVID and Sports Concussions - fullmetal - 04-05-2023

At the very least, coaches should make sitting out the default protocol upon which athletes would have to voluntarily opt back into practice, knowing the risks.  But it seems unethical to allow student-athletes this highly risky choice...


RE: COVID and Sports Concussions - M T - 04-05-2023

(04-05-2023, 07:55 AM)81alum Wrote:  It raises lots of questions.  1) Should athletes be held out of practice and gameplay for 60 days after having COVID, to reduce their risks?  2) Should athletes be kept on COVID boosters even after vaccine mandates expire for everyone else, to reduce their concussion risk?

The questions of "Should" above leaves out the agent that would encourage or set such a policy. The player? The player's physician? The team's medical staff?  The school (or club)?  The organizing body (conference, NCAA, NFL, etc)?  The cognizant health officer (county and/or state public health officer)?   The FDA?  The government (state or federal) by law or regulation? 

Unintended consequences would include further pressure for the athletes to choose to NEVER get tested for Covid.  I already hear it from people I know that "It's just a sore throat.  If it gets worse, then I'll test."

I was pretty certain that one well-known coach sabotaged his subsequent tests after a positive test meant that he wouldn't be allowed to coach for a while. (He claimed a false positive on a test that has a vanishingly small chance of a false positive.)  I can imagine other athletes & coaches would do the same.

We saw that the population in general, and many individuals, want the freedom to damage their health rather than to abide by measures intended to protect them.   (Unfortunately, one person's freedom to avoid such measures impacts the health of many others.)

Perhaps an interesting question might be whether an athlete can give informed consent to play after COVID, giving up the right to sue for (in this case) damage from concussions that might have been related to playing after COVID?


I expect the FDA decision for once-a-year boosters presumed no further effects than already known.  But that's getting increasingly more difficult to determine, I'd think.  Most of the population has had COVID at least once.   If, for instance, after 2023 syndrome X has an incidence of 20% when before 2020 it was just 10%.  Then, could that increase be caused by COVID or other factors (the COVID shutdown, increased screening, etc.)?  (Likewise, the incidence of other syndromes might fall.)

FYI, here in early April, it looks like the flu & RSV have dropped to very low levels, but COVID and HPMV are still going strong (but not at a peak).


RE: COVID and Sports Concussions - Jamesy - 04-05-2023

Need to be careful with correlation vs causation. I think the more likely explanation is that the isolation period with limited to no activity leads to deconditioning and higher risk for concussion in that respect than covid making an athlete more susceptible to concussion. I believe there is similar data showing risk of concussion is higher when an athlete is returning from injury.


RE: COVID and Sports Concussions - dabigv13 - 04-05-2023

Pretty suspicious of this finding without a really plausible mechanism. Would be pretty novel for a viral infection to predispose to concussions, something that has never before been linked.

A link to sudden sensorineural hearing loss is much more plausible but I think still unclear if covid is any more likely to cause it than other viral infections.


RE: COVID and Sports Concussions - 81alum - 04-05-2023

(04-05-2023, 08:12 PM)dabigv13 Wrote:  Pretty suspicious of this finding without a really plausible mechanism. Would be pretty novel for a viral infection to predispose to concussions, something that has never before been linked.

A link to sudden sensorineural hearing loss is much more plausible but I think still unclear if covid is any more likely to cause it than other viral infections.
I'll defer to our medical professionals who inhabit this board (maybe you?) but the plausible link is pretty obvious:  long COVID has known neurological symptoms.


RE: COVID and Sports Concussions - Mick - 04-06-2023

(04-05-2023, 08:12 PM)dabigv13 Wrote:  Pretty suspicious of this finding without a really plausible mechanism. Would be pretty novel for a viral infection to predispose to concussions, something that has never before been linked.

A link to sudden sensorineural hearing loss is much more plausible but I think still unclear if covid is any more likely to cause it than other viral infections.

And the audiologist was quick to state the same, that it was likely a virus and that she had seen a remarkable rise of sudden sensorineural hearing loss since the Omicron variant, but that correlation was not causation, and it could have certainly been another virus.


RE: COVID and Sports Concussions - 81alum - 04-06-2023

Here is a study going in the other direction, investigating whether a history of concussion increases the odds of COVID becoming long COVID.  This study is just getting started, though:

https://medicalxpress.com/news/2022-08-history-concussions-odds-covid.html

Quote:Some markers in patients' blood during a COVID-19 infection are similar to those in patients who've had a concussion, Linseman said. That suggests that while a viral infection and a hit on the head may feel different to patients, they could share some underlying biology.

And a Denver study looking at the similarities between concussion and long COVID:

https://www.du.edu/news/du-study-finds-similarities-diagnosis-and-treatment-concussions-and-long-covid

Quote:“A lot of it is thinking about which parts of the brain are affected when COVID enters,” Stoot says. “If we talk about where our sense of taste and smell is, it’s located in our brain stem. If we talk about the area that gets dinged when you have a concussion, it’s also in our brain stem.”

As expected, the study found similarities between the effects of long COVID and the effects of concussions. While it remains unclear why, both diseases involve brain inflammation, meaning they could involve similar treatments.



RE: COVID and Sports Concussions - TrumpCard - 04-06-2023

(04-05-2023, 09:59 AM)Mick Wrote:  I think there's a lot we don't know about the aftermath of COVID for those who've been infected.

Early last year, I had a sudden and total hearing loss in my right ear, about 90 days after I had the Omicron variant. It wasn't gradual, I woke up one day and it was gone. I met with several audiologists and an ENT specialist at Sutter Health. The audiologist asked if I'd experienced a sudden very loud noise (no), a blow to the head (no), blood clots (no). She then asked if I'd been infected with COVID. She said that ever since the Omicron variant, she'd seen a marked increase in people suffering from SSNHL (Sudden Sensorineural Hearing Loss). There was no proof, not at the time, but the theory was that the nerves in the ear responsible for hearing are susceptible to COVID.  

Here's a few links:

COVID-19 could lead to long-term hearing issues according to studies
Sensorineural Hearing Loss Post-COVID-19 Infection: An Update - PMC (nih.gov)
COVID-19 and Hearing Loss | Ear, Nose and Throat Services

I had four steroids shots behind my eardrum and a regimen of antivirals.  Got back about 35% of my hearing.

I’m so sorry this happened to you. The morning you woke up with no hearing in one ear must have been so scary. I hope you experience some additional improvement with time or treatment.


RE: COVID and Sports Concussions - Mick - 04-06-2023

(04-06-2023, 09:52 AM)TrumpCard Wrote:  
(04-05-2023, 09:59 AM)Mick Wrote:  I think there's a lot we don't know about the aftermath of COVID for those who've been infected.

Early last year, I had a sudden and total hearing loss in my right ear, about 90 days after I had the Omicron variant. It wasn't gradual, I woke up one day and it was gone. I met with several audiologists and an ENT specialist at Sutter Health. The audiologist asked if I'd experienced a sudden very loud noise (no), a blow to the head (no), blood clots (no). She then asked if I'd been infected with COVID. She said that ever since the Omicron variant, she'd seen a marked increase in people suffering from SSNHL (Sudden Sensorineural Hearing Loss). There was no proof, not at the time, but the theory was that the nerves in the ear responsible for hearing are susceptible to COVID.  

Here's a few links:

I had four steroids shots behind my eardrum and a regimen of antivirals.  Got back about 35% of my hearing.

I’m so sorry this happened to you. The morning you woke up with no hearing in one ear must have been so scary. I hope you experience some additional improvement with time or treatment.

Yeah, me too. I actually thought I had a bug in my ear. Hearing was totally gone, profound loss. After the steroids, the effect was interesting...basically, it sounds exactly as if someone is speaking to you with their hand over their mouths.

Good news was that my stingy insurance company paid for top-of-the-line hearing aids. Great for volume, doesn't do much for clarity and doesn't eliminate background noise. 

Audiologist noted a funny side effect on my general, age-related hearing loss--I could hear deeper sounds, but not higher-pitched sounds. In other words, she said, you can hear men, but not women as well. Imagine my wife's delight at that pronouncement... ;)

One final comment...the ENT at Sutter Health was remarkably, almost stunningly unsympathetic, tbh. A Midwesterner, and not a Stanford grad, btw. All my other medical professionals were wonderful in that regard.


RE: COVID and Sports Concussions - newguy - 04-07-2023

(04-06-2023, 10:16 AM)Mick Wrote:  One final comment...the ENT at Sutter Health was remarkably, almost stunningly unsympathetic, tbh. A Midwesterner, and not a Stanford grad, btw. All my other medical professionals were wonderful in that regard.

It's truly disappointing how unsympathetic some doctors can be.