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Introduction: An infection with SARS-CoV-2 is relevant especially in high-performance sport due to possible organ damage and reduced performance which occurs in individual cases. Various recommendations are found in the literature concerning when safe return to sports is possible and what examinations are suitable to support this decision. The dominance of other virus variants than those at the start of the pandemic makes revision of earlier recommendations necessary. Methods and Analysis: The recommended actions are based on the currently-available scientific knowledge of the pathogenicity of the virus and on clinical experiences in general and elite athletes. Twenty-one recommended actions were proposed by the Scientific Council of the DGSP, discussed and agreed on in consensus with experts from German-language sports-medical facilities and evaluated by an independent co-author. The resultant position paper was subsequently released by mutual agreement. Results: The recommendations are oriented to the severity of the course and the symptoms. The required medical diagnostic is deduced therefrom. During persistent symptoms, sports should be paused and training only begun again at low intensity after a three-day symptom-free period. If COVID-19-associated complaints recur, physical exertion should be stopped and a doctor consulted. After moderate and serious course, medical diagnostics are required prior to the start of training. Summary: To prevent a health risk due to sports and thereby resultant organ damage after a SARS-CoV-2 infection, a procedure adapted to the symptoms and course before return to training and finally to competitive sports is recommended.

Problem: Due to physical performance limitations and inactivity after pediatric oncological treatment there is a strong need for childhood cancer-specific exercise opportunities. However, only few sustainable programs have been described in the literature. This article aims to provide an example of implementing an exercise opportunity in pediatric oncology.Methods: Five-year data (May 2012 to May 2017) have been analyzed on adverse events, attendance rates and barriers to attendance of a group-based exercise program designed for childhood cancer patients after inpatient medical treatment. The exercise sessions included endurance, strength, coordination exercises, as well as relaxation and cooperative games and were offered once a week for 45-60 minutes. In addition, aspects of reintegration into non-cancer-specific PA were explored.Results: Over 5 years, 32 patients and 14 healthy siblings/friends between 3 and 18 years of age were included. Most patients joined the program for 6-18 months with an average attendance rate of the exercise sessions of 60.28 12.62%. Main reasons for non-attendance of single exercise sessions were medical issues and holidays. No severe adverse events occurred. At program completion, most patients participated in physical education at school/kindergarten and engaged in leisure-time PA.Discussion: While key aspects for the establishment of sustainable exercise opportunities are highlighted, reintegration into non-cancer-specific PA must be improved and home-based alternatives could be a beneficial complement to the program.Key Words:Childhood, Children, Cancer, Sports, Physical Performance

Increased levels of physical activity are associated with a risk reduction for several neurodegenerative disorders (e.g. Multiple Sclerosis, Parkinsons disease). Moreover, physical exercise is known to improve the physical capacity and to reduce commonlyobserved symptoms, such as motoric, cognitive and a ective impairments. In addition to the ameliorating e ects on speci c symptoms, rst evidence also suggests that physical exercise interventions may counteract and/or alleviate the progress of these diseases.Considering the side effects of drug therapy, exercise interventions represent a promising non-pharmacological supportive treatment option and are therefore increasinglybeinginvestigated in clinical research on neurological diseases.More knowledge about the underlying biological mechanisms is warranted in order to improve tailored exercise programs. However, the reduced accessibility of the central nervous system in humans and problems in the transferability of rodent models complicates research in this eld. Nevertheless, several peripheral markers indicating distinct biological pathways involved in the pathogenesis and progression of neurodegeneration have been revealed to date. Interestingly, these biomarkers have recently been described to be sensitive to exercise stimuli. In this review, we provide an overview of the interaction between potential mechanisms linked to physical exercise and the alleviation of neurodegenerative processes. More precisely, we focus on di erent aspects of exercise-induced impacts on neuronal growth factors, in ammation, blood-brain barrier permeability and the kynurenine pathway.KEY WORDS: Exercise, Physical Activity, Brain, Neurodegeneration, Neurological Disorders

We assessed whetherthe seasonal training pattern of endurance athletes produces corresponding adaptations of mitochondrial, angiogenic, and myogenic processes in skeletal muscle and whether these relate to the training volume and metabolic load during exercise. Aerobic performanceand content per actin of markers of mitochondrial respiration (NDUFA9, SDHA, UQCRC1, COX4AI, ATP5A1, UCP3), myogenic regulators (myogenin, myoD, tenascin-C) and MyHC were determined in m. vastus lateralis of ten male elite junior cyclists (17.30.2 years) after the preparation and competition phase over two seasons. Effects were assessed with a repeated measures ANOVA at a 5% significance level.'Energy spent in training was comparable in the preparation and competition phase of the first season (9354 and 9825 MET x min/week), despite a 14%-reduced training volume, but decreased thereafter to 6800 MET x min/week. Average mitochondrial protein content changed in anti-cyclical pattern to VO2peak, capillarisation, satellite cell and myonuclear number; being 22% and 45% higher after the preparation than the preceding competition phase in season 1 and 2. The content of tenascin-C (+34%), and myogenin (+166%), increased transiently after the second preparation phase. The findings emphasize a role of seasonal metabolic load for adjustments in muscle protein expression with training of junior cyclists and suggest that the capacity for mitochondrial biogenesis may become exhaustedat the end of the competition phase when muscle enters a regeneration program.KEY WORDS: Competition, Training, Plasticity, Molecular Biology