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Observational Study
. 2023 May;182(5):2421-2432.
doi: 10.1007/s00431-023-04880-x. Epub 2023 Mar 14.

SARS-CoV-2 transmission in teenagers and young adults in Fútbol Club Barcelona's Multidisciplinary Sports Training Academy

María Hernández-García  1 , Quique Bassat  1   2   3   4   5 , Victoria Fumado  3   6   7   8 , Gil Rodas  9   10 , Ramon Pi  10 , Maite Miranda-Garcia  7   11 , Mònica Girona-Alarcón  7   12 , Martí Català  13 , Sergio Alonso  14 , Enrique Alvarez-Lacalle  14 , Daniel López  14 , Maria Melé-Casas  1 , Gemma Pons-Tomas  1 , Mariona F de Sevilla  1   3   7   8 , Elisenda Bonet-Carne  7   15   16   17 , Claudia Fortuny  3   6   7   8 , Aleix García-Miquel  11   15 , Cristina Jou  7   18   19 , Cristina Adroher  20 , Joana Claverol  7   11 , Marta Cubells  7   11 , Anna Codina  7   18 , Daniel Cuadras  21 , Eduard Gratacós  7   15   16   19 , Pedro Brotons  3   7   22 , Carmen Muñoz-Almagro  3   22   23 , Clara Prats  14 , Juan José García-García #  24   25   26   27 , Iolanda Jordan #  3   7   8   12
Affiliations
Observational Study

SARS-CoV-2 transmission in teenagers and young adults in Fútbol Club Barcelona's Multidisciplinary Sports Training Academy

María Hernández-García et al. Eur J Pediatr. 2023 May.

Abstract

Most studies, aimed at determining the incidence and transmission of SARS-CoV-2 in children and teenagers, have been developed in school settings. Our study conducted surveillance and inferred attack rates focusing on the practice of sports. Prospective and observational study of those attending the sports facilities of Fútbol Club Barcelona (FCB), in Barcelona, Spain, throughout the 2020-2021 season. Participants were young players (from five different sports) and adult workers, who belonged to stable teams (shared routines and were involved in same quarantine rules). Biweekly health questionnaires and SARS-CoV-2 screening were conducted. From the 234 participants included, 70 (30%) both lived and trained in the FCB facilities (Recruitment Pathway 1;RP1) and 164 (70%) lived at their own household and just came to the facilities to train (RP2). During the study, 38 positive cases were identified; none had severe symptoms or needed hospitalization. The overall weekly incidence in the cohorts did not differ compared to the one expected in the community, except for 2 weeks when an outbreak occurred. The attack rate (AR) was three times higher for the participants from RP1, in comparison to those from RP2 (p < 0.01). A Basketball team showed a significant higher AR. Conclusion: Physical activities in stable teams are not related to an increased risk of transmission of SARS-CoV-2, since there were the same observed cases than expected in the community. The risk is higher in indoor sports (Basketball vs. Football), and in closed cohort living settings (RP1 vs. RP2). The fulfilment of preventive measures is essential. What is Known: • Despite the low numerical impact caused in paediatric hospitalizations during COVID-19 pandemic, the social impact has been maximum. • The transmission potential in children and teenagers is limited, and it had been widely demonstrated in school settings. What is New: • Group physical activities in children and teenagers are not also related to an increased risk of transmission of SARS-CoV-2, when preventive measures, such as washing hands, and screening protocols are applied. • Routine and semi-professional sports activities seem safe environments to promote during this pandemic.

Keywords: Adolescent; COVID-19; SARS-CoV-2; Sports; Transmission; Youth sports.

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Conflict of interest statement

Authors Enrique Alvarez-Lacalle, Daniel López and Clara Prats declare: Grants or contracts: SARS-CoV-2 and other respiratory viruses in childhood: different focuses to define predictive models for its diagnosis and epidemiological evolution. Funds paid to the university. Fundació La Marató. CNECT/LUX/2020/LVP/0085, LC-01591965. PI: Clara Prats. Funds paid to the university. European Commission, DG-CONNECT. Authors Daniel López and Clara Prats declare as well: Grants or contracts: Competitive research project funded by the Spanish government (PGC2018-095456-B-I00). PI: Clara Prats. Funds paid to the university. Ministerio de Ciencia e Innovación, Gobierno de España. Monitoring of COVID-19 epidemic in Catalonia (Spain). PI: Clara Prats. Funds paid to the university. Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Authors Enrique Alvarez-Lacalle and Clara Prats declare as well: Consulting fees: JANSSEN CILAG SA, for the monitoring and prediction of COVID-19 incidence in Spanish regions in the context of the Phase III clinical trial of their vaccine. Funds paid to the university. None of the previous statements has been directly or indirectly related to the work submitted for publication. The rest of the authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
October 2020 positive cases outbreak (21st to 30th October). The cases are differentiated in three rounds according to the dates of the first positive test (PCR or Ag) or the first symptom, in order to show the temporal evolution (blue, cases dated between 21st and 22nd October; red, cases dated between 23rd and 24th October; black, cases dated between 26 and 30th October). They are included in their Sport and Category “Bubble” (teams, green circles) as well as in their household “bubble” (in or out the Masia, in the Masia being included in the red circle). The grey numbers indicate the size of the tracked cohorts. Absence of grey number indicates that such team was not included as a whole in the study (i.e. the participant was followed through the Masia)
Fig. 2
Fig. 2
Expected and detected positive cases, and number of performed tests. A Number of PCR, Ag test and serologies performed during the study, per week and divided into age ranges. B Probability of detecting 0 to 4 positives each week, based on the tests performed. C Number of positive cases reported compared to those expected (taking as a reference the incidence of positive cases at the same moment in the surrounding areas of the FCB facilities), with 95% CI (for the expected cases)
Fig. 3
Fig. 3
Description of the seroconversion throughout the study. Of the 234 participants, 225 were the ones who underwent both initial and final serology during the whole study. From the 179 participants, with an initial negative serology, for whom a positive SARS-CoV-2 result was never documented, 36 (20.1%) had seroconverted by the end of the study. *Of these 36 participants, 20 (55%) were vaccinated against SARS-CoV-2 during the study, so the positive IgG are explained by the immunization. From the other 16 participants: 8 (22.5%) of them did have a positive test, although it was done outside the study (through the primary care center or privately), and the remaining 8 (22.5%) had no data of a positive test either inside or outside the study
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