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The gradual return of sports training and competition presents a number of obvious logistical and ethical challenges for professional leagues and players, but largely hinges on the premise that the athletes are “low-risk candidates” to contract COVID-19.
But a handful of immunocompromised athletes will face a more nuanced decision regarding their own safety, as addressed by the New York Times’ Marc Stein in a tweet about Cleveland Cavaliers center Larry Nance Jr. Thursday.
Nance Jr. was diagnosed with Crohn’s Disease at 16 and receives a 2 ½- to 3-hour infusion of the drug Remicade – which is commonly used to weaken overactive immune responses – every six weeks during the NBA season. He told Stein he plans to join his team at its practice facility for voluntary workouts when it reopens Friday.
Nance Jr. is not alone among professional athletes who will have to consider their personal risk, however. Oakland Athletics pitcher Jake Diekman has openly discussed his longtime battle with Ulcerative Colitis, and Olympic gold medalist in swimming Kathleen Baker also has Crohn’s.
Baker’s stance differs from Nance Jr.’s – she told Yahoo Sports she’s wary of returning to competition any time soon.
“I feel like most people who are 23 years old are not worrying the way I am,” Baker, who was diagnosed with Crohn’s disease at age 10, said in April. “For me, getting the flu can lead to pneumonia, or when I get strep throat, a 104-degree fever and maybe some IV antibiotics.”
According to the American College of Gastroenterology, inflammatory bowel diseases like Crohn’s do not increase a patient’s risk to contract the coronavirus, but many of the treatments for such diseases do.
Baker takes a biologic to keep her disease in check, as well as stronger steroids in emergency situations.
As opposed to general immunosuppressant steroids, biologic therapies target specific pathways in the body, but still can leave patients more susceptible to catching viruses as well as potentially having more severe reactions to anything they do contract. IBD patients will commonly pair an immunosuppressant steroid with their biologic.
The San Diego-based gold medalist said she’s been wearing masks during travel since long before the pandemic, and because she’s part of an at-risk group, now goes to the local grocery store during designated hours prior to its opening to the general public.
“It’s sort of weird being asked what’s wrong with me in the grocery store line – because I don’t look sick,” Baker said. “It’s something you have to struggle with having an invisible illness like Crohn’s disease.”
Baker, who is currently practicing in a two-lane backyard pool, said she would “absolutely not” attend a swim meet in the near future – the vast majority of swimming events have been canceled through the summer.
“I have found it a little harder during this period just because people are like ‘you’re healthy, you’re 20-something, you’re gonna be fine if you get it,’ but in reality, I have a chronic illness and I’m immunocompromised so they don’t know how it’s going to affect me,” Baker said.
“I’m still trying to make the Olympic team in 2021 now, so I can’t just hope that I get the virus and I recover.”
Do risk factors exist?
Drugs like Remicade should keep Nance Jr.’s disease in check and help him avoid hospital visits amid the pandemic, a paramount goal for IBD patients at this time, but it could also make him more vulnerable to infection. Stein reported that Nance Jr. “has confidence” in his medication.
In March, Nance Jr. took part in a live-streamed Q&A session with an expert in the field through his foundation – Athletes vs. Crohn’s & Colitis – to help other patients, and himself, understand their risk factors for COVID-19.
During that discussion, Dr. Marla Dubinsky stressed that there was no evidence that common IBD medications, including the one Nance Jr. takes, increase the risk for contracting COVID-19. Dubinsky reaffirmed that data in a later chat as well.
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