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

Azeli, Youcef; Rio, Sonia; Toledo, Yobanka; Grazioli, Gonzalo; Brotons, Daniel; Solà-Muñoz, Silvia; Jiménez-Fàbrega, Xavier; Escalada-Roig, Xavier et al. · Med Sci Sports Exerc · 2025

retrospective_cohort · Level III

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Abstract

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. Retrospective observational study. Autopsied SrSD studied in Catalonia was 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. 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 yr (SD, 12.1). Cycling was practiced 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 cardiopulmonary resuscitation (CPR) attempt. After lockdown, the SrSD that occurred in country areas decreased (40.6% vs 24.4%, P = 0.032), and 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). 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.

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