Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete’. Snyders, C., Pyne, D. B., Sewry, N., Hull, J. H., Kaulback, K., & Schwellnus, M. British Journal of Sports Medicine, 56(4):223–232, BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine, February, 2022. ![Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete’ [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Objective To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in \textgreater1 day lost from training/competition, and symptom duration (days) of ARill in athletes. Design Systematic review and meta-analysis. Data sources PubMed, EBSCOhost, Web of Science, January 1990–July 2020. Eligibility criteria Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss \textgreater1 day after ARill or symptom duration (days) of ARill. Results 767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss \textgreater1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens). Conclusions In 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS. PROSPERO registration number CRD42020160479.
@article{snyders_acute_2022,
chapter = {Review},
title = {Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the {IOC} consensus on ‘acute respiratory illness in the athlete’},
volume = {56},
copyright = {© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.},
issn = {0306-3674, 1473-0480},
shorttitle = {Acute respiratory illness and return to sport},
url = {https://bjsm.bmj.com/content/56/4/223},
doi = {10.1136/bjsports-2021-104719},
abstract = {Objective To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in {\textgreater}1 day lost from training/competition, and symptom duration (days) of ARill in athletes.
Design Systematic review and meta-analysis.
Data sources PubMed, EBSCOhost, Web of Science, January 1990–July 2020.
Eligibility criteria Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (\%) of time loss {\textgreater}1 day after ARill or symptom duration (days) of ARill.
Results 767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (\%) of time loss {\textgreater}1 day after ARill was 20.4\% (95\% CI 15.3\% to 25.4\%). The mean symptom duration for all ARill was 7.1 days (95\% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens).
Conclusions In 80\% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.
PROSPERO registration number CRD42020160479.},
language = {en},
number = {4},
urldate = {2025-12-10},
journal = {British Journal of Sports Medicine},
publisher = {BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine},
author = {Snyders, Carolette and Pyne, David B. and Sewry, Nicola and Hull, James H. and Kaulback, Kelly and Schwellnus, Martin},
month = feb,
year = {2022},
keywords = {athletes, infection, respiratory system},
pages = {223--232},
}
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Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.","issn":"0306-3674, 1473-0480","shorttitle":"Acute respiratory illness and return to sport","url":"https://bjsm.bmj.com/content/56/4/223","doi":"10.1136/bjsports-2021-104719","abstract":"Objective To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in \\textgreater1 day lost from training/competition, and symptom duration (days) of ARill in athletes. Design Systematic review and meta-analysis. Data sources PubMed, EBSCOhost, Web of Science, January 1990–July 2020. Eligibility criteria Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss \\textgreater1 day after ARill or symptom duration (days) of ARill. Results 767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss \\textgreater1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens). Conclusions In 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS. PROSPERO registration number CRD42020160479.","language":"en","number":"4","urldate":"2025-12-10","journal":"British Journal of Sports Medicine","publisher":"BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine","author":[{"propositions":[],"lastnames":["Snyders"],"firstnames":["Carolette"],"suffixes":[]},{"propositions":[],"lastnames":["Pyne"],"firstnames":["David","B."],"suffixes":[]},{"propositions":[],"lastnames":["Sewry"],"firstnames":["Nicola"],"suffixes":[]},{"propositions":[],"lastnames":["Hull"],"firstnames":["James","H."],"suffixes":[]},{"propositions":[],"lastnames":["Kaulback"],"firstnames":["Kelly"],"suffixes":[]},{"propositions":[],"lastnames":["Schwellnus"],"firstnames":["Martin"],"suffixes":[]}],"month":"February","year":"2022","keywords":"athletes, infection, respiratory system","pages":"223–232","bibtex":"@article{snyders_acute_2022,\n\tchapter = {Review},\n\ttitle = {Acute respiratory illness and return to sport: a systematic review and meta-analysis by a subgroup of the {IOC} consensus on ‘acute respiratory illness in the athlete’},\n\tvolume = {56},\n\tcopyright = {© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.},\n\tissn = {0306-3674, 1473-0480},\n\tshorttitle = {Acute respiratory illness and return to sport},\n\turl = {https://bjsm.bmj.com/content/56/4/223},\n\tdoi = {10.1136/bjsports-2021-104719},\n\tabstract = {Objective To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in {\\textgreater}1 day lost from training/competition, and symptom duration (days) of ARill in athletes.\nDesign Systematic review and meta-analysis.\nData sources PubMed, EBSCOhost, Web of Science, January 1990–July 2020.\nEligibility criteria Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (\\%) of time loss {\\textgreater}1 day after ARill or symptom duration (days) of ARill.\nResults 767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (\\%) of time loss {\\textgreater}1 day after ARill was 20.4\\% (95\\% CI 15.3\\% to 25.4\\%). The mean symptom duration for all ARill was 7.1 days (95\\% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens).\nConclusions In 80\\% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.\nPROSPERO registration number CRD42020160479.},\n\tlanguage = {en},\n\tnumber = {4},\n\turldate = {2025-12-10},\n\tjournal = {British Journal of Sports Medicine},\n\tpublisher = {BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine},\n\tauthor = {Snyders, Carolette and Pyne, David B. and Sewry, Nicola and Hull, James H. and Kaulback, Kelly and Schwellnus, Martin},\n\tmonth = feb,\n\tyear = {2022},\n\tkeywords = {athletes, infection, respiratory system},\n\tpages = {223--232},\n}\n\n\n\n\n\n\n\n","author_short":["Snyders, C.","Pyne, D. B.","Sewry, N.","Hull, J. 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