VCOM Louisiana Research Day Program

COVID-19 & Epidemiology

Randy L. Aldret, EdD, LAT, ATC, CSCS*D; Alyssa Juneau, OMS-III; Stephanie N. Aldret, DO, CAQSM Edward Via College of Osteopathic Medicine-Louisiana 38 THE ASSOCIATION BETWEEN ACUTE CONCUSSION SYMPTOMS AND PREVIOUS COVID-19 DIAGNOSIS IN A NCAA DIVISION-1 ATHLETIC POPULATION

We are only now beginning to understand the effects of the long-term, post-COVID sequelae that are present in 15-20% of diagnosed positive cases in patients aged 18-34 years. Some of the symptoms present in the long-term, post COVID patients are also seen in collegiate student-athletes with a diagnosed concussion. Headache, depression, anxiety, exercise intolerance, and sleep disturbances are among the cognitive, vestibular and psychological issues faced by patients of both conditions. The researchers wanted to better understand the intersection of post-COVID sequelae and its potential to expose student-athletes to an exacerbation of acute concussion symptoms. A systematic chart review of a student-athlete population from a NCAA Division-1 was conducted to identify those that had sustained a concussion from the period of March 2019 to June 2022. From this population, athletes were separated into groups of having a COVID-19 diagnosis prior to their concussion diagnosis and those that did not have a COVID-19 diagnosis prior to their concussion. From this population, initial symptom data was gathered for all 45 subjects according to the 22 symptoms class criteria utilized by the latest Sports Concussion Assessment Tool (SCAT5) symptom scale. Additional data on previous concussion

history, previous diagnosis of migraine, and sport were also collected. The population of 45 diagnosed with a concussion included 23 males and 22 female student-athletes across 10 different sports. Of this population of 45, 17 had a diagnosis of COVID-19 at some time prior to their concussion. 25 subjects had a previous history of concussion; 15 subjects had a previous diagnosis of migraine headaches; 9 subjects had a previous history of both. Linear regression modeling of previous positive COVID-19 diagnosis and the initial symptom scores revealed a R 2 of 0.667 with an adjusted R 2 of 0.361, which demonstrated a significant difference between concussed subjects with a COVID-19 diagnosis versus those without a COVID-19 diagnosis (p=0.036). Significant differences were observed in four specific symptoms: “Pressure in Head” (p=0.041); “Sensitivity to Noise” (p=0.05); “Confusion” (p=0.009); and “Trouble Falling Asleep” (p=0.011). Although supported by previous concussion literature, there were no significant differences between COVID-19 groups symptoms when comparing by gender, sport participation, previous history of concussion or previous history of migraine. Student-athletes with a previous COVID-19

diagnosis have a significant increase in symptoms experienced acutely after

concussion. Noise sensitivity, trouble falling asleep, head pressure, and confusion were significantly increased in the COVID-19 positive group. Future investigation should examine if time since a COVID-19 diagnosis has a dose response effect on the magnitude, frequency, and duration of concussion symptoms. As we continue to investigate the long-term effects of COVID-19 infection, it will benefit sports medicine practitioners to include a previous COVID-19 infection as a potential predisposing factor in concussion symptom scoring and management.

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