Snyders, CaroletteSewry, Nicola AnnDerman, WayneEken, Maaike MariaJordaan, EsmeSwanevelder, SonjaSchwellnus, Martin Peter2024-08-292024-08-292024-09Snyders, C., Sewry, N., Derman, W. et al. 2024, 'Incidence of respiratory infections and SARS-CoV-2 is higher during contact phases in student rugby players – lessons learnt from COVID-19 risk mitigation strategies–AWARE V', Sports Medicine and Health Science, vol. 6, no. 3, pp. 252-259, doi : 10.1016/j.smhs.2024.03.005.2666-3376 (online)10.1016/j.smhs.2024.03.005http://hdl.handle.net/2263/97930The incidence of acute respiratory infections (ARinf), including SARS-CoV-2, in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is unknown. The aim of the study was to determine the incidence of ARinf (including SARS-CoV-2) during non-contact and contact phases during the COVID-19 pandemic to evaluate risk mitigation strategies. In this retrospective cohort study, 319 top tier rugby players from 17 universities completed an online questionnaire. ARinf was reported during 4 phases over 14 months (April 2020–May 2021): phase 1 (individual training), phase 2 (non-contact team training), phase 3 (contact team training) and phase 4 (competition). Incidence (per 1 000 player days) and Incidence Ratio (IR) for ‘All ARinf’, and subgroups (SARS-CoV-2; ‘Other ARinf’) are reported. Selected factors associated with ARinf were also explored. The incidence of ‘All ARinf’ (0.31) was significantly higher for SARS-CoV-2 (0.23) vs. ‘Other ARinf’ (0.08) (p ​< ​0.01). The incidence of ‘All ARinf’ (IR ​= ​3.6; p ​< ​0.01) and SARS-CoV-2 (IR ​= ​4.2; p ​< ​0.01) infection was significantly higher during contact (phases 3 ​+ ​4) compared with non-contact (phases 1 ​+ ​2). Demographics, level of sport, co-morbidities, allergies, influenza vaccination, injuries and lifestyle habits were not associated with ARinf incidence. In student rugby, contact phases are associated with a 3–4 times higher incidence of ARinf/SARS-CoV-2 compared to non-contact phases. Infection risk mitigation strategies in the contact sport setting are important. Data from this study serve as a platform to which future research on incidence of ARinf in athletes within contact team sports, can be compared.en© 2024 Chengdu Sport University. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY-NC-ND license.Acute respiratory infection (ARinf)Coronavirus disease 2019 (COVID-19)COVID-19 pandemicAthletesRiskPreventionEpidemiologySevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)SDG-03: Good health and well-beingArticle