Magnetic resonance (MR) studies suggested cardiac involvement post‐Covid‐19 in a significant subset of affected individuals, including athletes. This brings serious clinical concerns regarding the potential need for in‐depth cardiac screening in athletes after Covid‐19 before return to play. The aim of this study was to gain further insight into the relation between Covid‐19 and cardiac involvement in professional athletes. This was a retrospective cohort study, in which 26 consecutive elite athletes (national team, Olympians, top national league players; median age 24 years, interquartile range [IQR] 21–27, 81% female) were included. At 1.5 T including balanced steady‐state free precession cine imaging, T1 and T2‐mapping using Myomaps software (Siemens), dark‐blood T2‐weighted images with fat suppression, and late gadolinium enhancement (LGE) with phase‐sensitive inversion recovery sequence were used. The athletes had mainly asymptomatic or mild course of the disease (77%). They were scanned after a median of 32 days (IQR 22–62 days) from the diagnosis. MR data were reviewed by three independent observers, each with >10 years cardiac MR experience. Native T1, T2, extracellular volume, and T2 signal intensity ratio were calculated. Diagnosis of acute myocarditis was based on modified Lake Louise criteria. Statistical analyses used were Pearson correlation and Bland–Altman repeatability analysis. At the time of MR the athletes had no pathologic electrocardiogram abnormalities or elevated troponin levels. MR did not reveal any case of acute myocarditis. Cardiac abnormalities were found in five (19%) athletes, including four athletes presenting borderline signs of isolated myocardial edema and one athlete showing nonischemic LGE with pleural and pericardial effusion. Another athlete had signs of persistent lung congestion without cardiac involvement. We have shown that in a small group of elite athletes with mainly asymptomatic to mild Covid‐19, lack of electrocardiographic changes, and normal troponin concentration 1–2 months after the diagnosis, there were no signs of acute myocarditis, but 19% of athletes had some abnormalities as assessed by cardiac MR.Level of Evidence: 4Technical Efficacy Stage: 3

Background: Athletes and coaches believe in the ergogenic effect of vitamin B₁₂ (which results from enhanced erythropoiesis) and they often insist on its unjustified supplementation. Therefore, our study aimed to assess the vitamin B₁₂ status in Polish elite athletes and its influence on red blood cell parameters. Methods: In total, 1131 blood samples were collected during six years from 243 track and field athletes divided into strength and endurance groups, as well as according to the declared use of vitamin B₁₂ injections. Results: An average vitamin B₁₂ concentration in all subjects was 739 ± 13 pg/mL, with no cases of deficiency. A weak but significant relationship was found between vitamin B₁₂ and hemoglobin concentrations. A significant increase in hemoglobin appeared from very low vitamin B₁₂ concentration and up to approx. 400 pg/mL, while hemoglobin did not significantly change from 700 pg/mL and onwards. Vitamin B₁₂ injections were used by 34% of athletes, significantly more often by endurance than by strength athletes. In athletes who declared no use of injections, a higher concentration of vitamin B₁₂ was observed in the endurance group. Conclusion: The main finding of the present study is the determination of the range of vitamin B₁₂ concentration which may favor better hemoglobin synthesis in athletes. They should regularly monitor vitamin B₁₂ concentration and maintain the range of 400–700 pg/mL as it may improve red blood cell parameters. We might suggest application of a supplementation if necessary. Special attention is required in athletes with a vitamin B₁₂ concentration below 400 pg/mL.

Objective Several studies have used the Sport Mental Health Assessment Tool 1 (SMHAT-1) among athletes but none have combined SMHAT-1 with a subsequent clinical intake interview. The aim of this study was to evaluate the diagnostic effectiveness of SMHAT-1 supplemented by a brief, in-person clinical intake interview in evaluating the prevalence of mental health concerns in elite athletes. Methods Sections 1 and 2 from SMHAT-1 were administered in person during the routine biannual medical check-up for Olympic athletes at the National Centre for Sports Medicine in Poland. Immediately after completing the measures, all athletes were interviewed by qualified psychologists who evaluated their mental health and provided recommendations. Results A total of 1121 elite athletes (545 female, 576 male) aged 18–53 (M=24.39, SD=5.09) were evaluated 2–8 months before the 2024 Paris Olympic Games; 72.4% scored above the triage threshold and 51% were positively screened in SMHAT-1’s section 2. Based on the subsequent mental health evaluation, only 9.5% showed signs of persistent mental health concerns and required referral to a mental health specialist. In 24.2%, their distress levels/symptoms were assessed as occasional and normal in relation to demands, and they underwent a psychoeducational intervention or were advised to consult a sports psychologist. Female athletes scored significantly higher in most questionnaires. Conclusion SMHAT-1 proved a useful addition to the routine medical check-ups for elite athletes. Extending SMHAT-1 with a brief clinical intake interview substantially elevated the efficacy of the mental health evaluation, with an additional benefit of raising mental health literacy.

Empirical research regarding the prevalence of mental health symptoms in Paralympic athletes is scarce. We aimed to evaluate the prevalence of mental health concerns in elite Paralympic athletes based on their scores in the IOC Sport Mental Health Assessment Tool 1 (SMHAT-1) and the subsequent in-person clinical intake interviews. In doing so, we also compared the prevalence of mental health symptoms and recommendations in the cohorts of Paralympic and Olympic athletes. We administered the SMHAT-1 (a state-of-the-art tool comprising screeners of psychological distress, depressive and anxiety symptoms, sleep disturbances, alcohol and other substances misuse, and disordered eating) during the routine biannual medical check-ups for all Paralympic athletes at the National Centre for Sports Medicine in Poland. Subsequently, all Paralympic athletes were interviewed by qualified sport psychologists who further evaluated the athletes’ mental health and provided recommendations. A total of 137 Paralympic athletes (87 males, 50 females) participated in the study three to eight months prior to the 2024 Paris Paralympic Games; 61% scored above the triage threshold for psychological distress. Based on the subsequent mental health evaluation, 75.2% of Paralympic athletes required no mental health action, 18.3% were advised psychoeducation or sport psychologist consultation, while 7.3% were referred to a mental health specialist—a psychotherapist and/or a psychiatrist. The proportion of mental health recommendations did not significantly differ between Paralympic and Olympic athletes. The SMHAT-1 proved a valuable basis for the subsequent brief clinical interviews, substantially elevated the efficacy of mental health evaluation, and aided in raising mental health literacy in Paralympic athletes.

Objective: Sport Mental Health Assessment Tool 1 (SMHAT-1) ensures comprehensive and reliable mental health screening in athletes. However, its triage’s predictive validity varies depending on the mental health domain (5%–60% false negative rates), while the full algorithm imposes a substantial time burden for routine screening. This study aimed to develop and validate a brief, clinically accurate alternative using the pool of items included in SMHAT-1. Methods: SMHAT-1 and subsequent brief clinical interviews were administered in Polish Olympic athletes over three waves of routine medical check-ups. An ant colony optimisation algorithm that evaluates item combinations holistically rather than sequentially was trained on two datasets (N ₁ =1121, N ₂ =803) to identify the optimal item subset predicting post-interview mental health recommendations. The solution underwent independent validation in the third dataset (N ₃ =1134). Results: The best solution comprised 18 items, achieved 81% accuracy in predicting the post-clinical interview mental health evaluation in the training datasets and 80% in an independent dataset, overperforming the SMHAT-1 triage on all performance indicators. The Athlete Mental Health Screen-18 (AMHS-18) demonstrated superior sensitivity (94%) and specificity (72%) at the optimal cut-off (≥19), with strong internal consistency (ω=0.82). Conclusion: The AMHS-18 is a time-efficient, valid and reliable tool for accurate mental health screening in athletes. It offers a practical alternative to the full SMHAT-1, particularly in settings where time and resources are limited or when athletes are screened regularly. We recommend using AMHS-18 instead of SMHAT-1’s triage and alternating SMHAT-1 with AMHS-18 as a starting point for routine brief clinical intake interviews.