COVID-19 in US Youth Soccer Athletes During Summer 2020

Context: As sports are reinitiated around the United States, the incidence of COVID-19 among youth soccer athletes remains unknown. Objective: To determine the incidence of COVID-19 among youth soccer athletes and the risk-mitigation practices used by youth soccer organizations. Design: Cohort study. Setting: Survey distributed to Elite Clubs National League member clubs. Patients or Other Participants: Youth soccer club directors throughout the United States. Main Outcome Measure(s): Surveys were completed in late August 2020 regarding the club's current phase of return to soccer (individual only, group noncontact, group contact), date of reinitiation, number of players, cases of COVID-19, and risk-reduction procedures being implemented. Case and incidence rates were compared with national pediatric data and county data from the prior 10 weeks. A negative binomial regression model was developed to predict club COVID-19 cases using the local incidence rate and phase of return as covariates and the log of club player-days as an offset. Results: A total of 124 respondents had reinitiated soccer, representing 91 007 players with a median duration of 73 days (interquartile range = 53-83 days) since restarting. Of the 119 clubs that had progressed to group activities, 218 cases of COVID-19 were reported among 85 861 players. Youth soccer players had a lower case rate and incidence rate than children in the United States (254 versus 477 cases per 100 000; incidence rate ratio = 0.511, 95% CI = 0.40, 0.57; P,.001) and the general population in the counties where data were available (268 versus 864 cases per 100 000; incidence rate ratio = 0.202, 95% CI = 0.19, 0.21; P < .001). After adjusting for the local COVID-19 incidence, we found no relationship between the club COVID-19 incidence and the phase of return (noncontact: b = 0.35 +/- 0.67, P =.61; contact: b = 0.18 +/- 0.67, P =.79). Soccer clubs reported using a median of 8 (interquartile range = 6-10) risk-reduction procedures. Conclusions: The incidence of COVID-19 among youth soccer athletes was relatively low when compared with the background incidence among children in the United States during the summer of 2020. No relationship was identified between the club COVID-19 incidence and the phase of return to soccer.