Kaulback, KellySchwellnus, Martin PeterSewry, NicolaJordaan, EsmeWood, Paola Silvia2025-03-242025-03-242024-01Kaulback, K., Schwellnus, M., Sewry, N. et al. 2024, 'Rating of perceived exertion associated with acute symptoms in athletes with recent SARS-CoV-2 infection : athletes with acute respiratory infection (AWARE) VI study', Journal of Athletic Training, vol. 59, no. 1, pp. 90-98. DOI: 10.4085/1062-6050-0632.221062-6050 (print)1938-162X (online)10.4085/1062-6050-0632.22http://hdl.handle.net/2263/101647CONTEXT : SARS-CoV-2 infection can affect the exercise response in athletes. Factors associated with the exercise response have not been reported. OBJECTIVE : To (1) describe heart rate (HR), systolic blood pressure (SBP), and rating of perceived exertion (RPE) responses to exercise in athletes with a recent SARS-CoV-2 infection and (2) identify factors affecting exercise Responses. DESIGN : Cross-sectional, experimental study. PATIENTS OR OTHER PARTCIPANTS : Male and female athletes (age ¼ 24.2 6 6.3 years) with a recent (,28 days) SARS-CoV-2 infection (n ¼ 72). SETTING : A COVID-19 Recovery Clinic for athletes. MAIN OUTCOME MEASURE(S) : Heart rate, SBP, and RPE were measured during submaximal exercise (modified Bruce protocol) at 10 to 28 days after SARS-CoV-2 symptom onset. Selected factors (demographics, sport, comorbidities, pre-infection training variables, and symptoms during the acute phase of the infection) affecting the exercise response were analyzed using random coefficient (linear mixed) models. RESULTS : Heart rate, SBP, and RPE increased progressively from rest to stage 5 of the exercise test (P ¼ .0001). At stage 5 (10.1 metabolic equivalents), a higher HR and a higher SBP during exercise were associated with younger age (P ¼ .0007) and increased body mass index (BMI; P ¼ .009), respectively. Higher RPE during exercise was significantly associated with a greater number of whole-body (P ¼ .006) and total number (P ¼ .004) of symptoms during the acute phase of infection. CONCLUSIONS : A greater number of symptoms during the acute infection was associated with a higher RPE during exercise in athletes at 10 to 28 days after SARS-CoV-2 infection. We recommend measuring RPE during the first exercise challenge after infection, as this may indicate disease severity and be valuable for tracking progress, recovery, and return to sport.en© by the National Athletic Trainers’ Association, Inc.ExercisePerformanceSDG-03: Good health and well-beingCOVID-19 pandemicCoronavirus disease 2019 (COVID-19)Return to sport (RTS)Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Article