medicina
Article
The Impact of the COVID-19 Pandemic on Endurance and
Ultra-Endurance Running
Volker Scheer 1,2
, David Valero 1, Elias Villiger 3
, Thomas Rosemann 3
and Beat Knechtle 3,4,*


Citation: Scheer, V.; Valero, D.;
Villiger, E.; Rosemann, T.; Knechtle, B.
The Impact of the COVID-19
Pandemic on Endurance and
Ultra-Endurance Running. Medicina
2021, 57, 52. https://doi.org/
10.3390/medicina57010052
Received: 9 December 2020
Accepted: 7 January 2021
Published: 9 January 2021
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distributed under the terms and con-
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license (https://
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4.0/).
1
Ultra Sports Science Foundation, 69310 Pierre-Bénite, France; volkerscheer@yahoo.com (V.S.);
dalevalero@gmail.com (D.V.)
2
Health Science Department, Universidad a Distancia de Madrid (UDIMA),
Collado Villaba, 28400 Madrid, Spain
3
Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland; evilliger@gmail.com (E.V.);
thomas.rosemann@usz.ch (T.R.)
4
Medbase St. Gallen Am Vadianplatz, 9006 St. Gallen, Switzerland
*
Correspondence: beat.knechtle@hispeed.ch
Abstract: Background and objectives: The COVID-19 outbreak has become a major health and economic
crisis. The World Health Organization declared it a pandemic in March 2020, and many sporting
events were canceled. Materials and Methods: We examined the effects of the COVID-19 pandemic
on endurance and ultra-endurance running (UER) and analyzed ﬁnishes and events during the
COVID-19 pandemic (observation period March 2020–October 2020) to the same time period pre-
COVID-19 outbreak (March 2019–October 2019). Results: Endurance ﬁnishes decreased during
the pandemic (459,029 to 42,656 (male: 277,493 to 25,582; female 181,536 to 17,074; all p < 0.001).
Similarly, the numbers of endurance events decreased (213 vs. 61 events; p < 0.001). Average
marathon ﬁnishing times decreased during the pandemic in men (5:18:03 ± 0:16:34 vs. 4:43:08 ±
0:25:08 h:min:s (p = 0.006)) and women (5:39:32 ± 0:19:29 vs. 5:14:29 ± 0:26:36 h:min:s (p = 0.02)).
In UER, ﬁnishes decreased signiﬁcantly (580,289 to 110,055; p < 0.001) as did events (5839 to 1791;
p < 0.001). Popular event locations in United States, France, UK, and Germany decreased signiﬁcantly
(p < 0.05). All distance and time-limited UER events saw signiﬁcant decreases (p < 0.05). Conclusions:
The COVID-19 pandemic has had a signiﬁcant effect on endurance and UER, and it is unlikely that
running activities return to pre-pandemic levels any time soon. Mitigation strategies and safety
protocols should be established.
Keywords: COVID-19; endurance running; marathon; ultra-endurance; running; sport industry
1. Introduction
The coronavirus (COVID-19) pandemic, due to the severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2), has become a major health and economic crisis around the
world during 2020 [1]. First reports of a new viral pneumonia appeared in December 2019
in Wuhan, China, and by January 2020, the World Health Organization (WHO) reported
of the spread of a new type of Coronavirus—COVID-19 [2]. The virus rapidly expanded
throughout the world, and in March 2020, the WHO declared it a pandemic [2]. Countries
around the world implemented travel restrictions, closed borders, and imposed local and
national lockdowns of varying degrees to reduce the spread of the virus and manage health
care resources [1].
These measures also included the cancelation of mass gathering and sporting events
in order to reduce and control the spread of the virus, as particularly mass gatherings and
sporting events on a large scale present unique challenges to public health authorities and
governments [3]. Undoubtedly, this has had adverse effects on the economy, with tourism
and sport tourism being important economic sectors and likely some of the sectors most
severely impacted due to lockdowns, travel restrictions, and closed borders [1,4]. The
Medicina 2021, 57, 52. https://doi.org/10.3390/medicina57010052
https://www.mdpi.com/journal/medicina
Medicina 2021, 57, 52
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extent to which this has affected endurance and ultra-endurance running (UER) events
and ﬁnishing numbers is not known.
The most prominent cancelations or (postponements) of sporting events due to the
COVID-19 pandemic are the Olympic Games in Tokyo 2020 and Union of European Football
Associations (UEFA) Euro 2020 Football Championships [3]. However, similarly, all other
professional and amateur sports, including football, basketball, golf, athletics, triathlon
etc. were initially canceled or postponed, with some professional sports (e.g., football,
basketball, golf) being allowed to resume sometime later despite ongoing lockdowns or
restrictions of movements under strict public health protocols [5,6].
Endurance running events in 2020 were no exception, with cancelation or postpone-
ments of big city marathons such as those in Berlin, Paris, Boston, New York, and London
due to safety concerns [7]. Some events were hosted as virtual competitions, whereas
others such as the Tokyo marathon 2020 were only open to elite runners [7]. This has
had important economic effects on the host city, as most of these big marathons attract
around 50,000 participants. For the New York City Marathon, it was estimated that, in
2014, the economic impact of the race was approximately 415 million US dollars [8]. Thus,
cancelation of any of these mass gathering events will likely have an important effect on
the sporting industry and the local economy. However, not only mass gathering events and
prominent races were canceled due to the COVID-19 pandemic but also many smaller and
local endurance events, with an impact on the local economy and the sporting community
that is still not fully understood, and its effects are difﬁcult to estimate.
Similarly, cancelation of ultra-endurance running (UER) events occurred, such as the
Ultra Trail du Mont-Blanc® 2020, one of the most well-known UER event worldwide that
usually attracts over 7000 participants from all around the world and with race distances of
up to 170 km [9]. Other iconic races, such as the Comrades marathon in South Africa, the
oldest ultramarathon, as well as the oldest 100 km race (Bieler Lauftage), the Spartathlon, a
246 km race in Greece, and many more UER were canceled or held virtually in 2020 [10,11].
The Two Oceans Marathon, a prominent race in South Africa, was also canceled in 2020, a
race that attracted over 34,000 participants in 2019 [4]. Many of these events were canceled
at short notice with considerable loss to the stakeholders, and in the case of the Two Oceans
Marathons, the estimated loss of revenue was thought to be in the region of 2 million
dollars [4]. However, considering endurance and UER events as a whole, the vast majority
of races are smaller events (e.g., the Al Andalus Ultra Trail in Spain or the Isle of Wight
Ultra Challenge in the UK) with fewer participant and less revenue at individual races;
nevertheless, they represent an integral part of the sporting community and the wider
sporting tourism branch.
Running is an important sporting activity and one of the most popular sports world-
wide that has seen an important increase in participation in endurance and UER events
over the last few decades [12,13]. Therefore, it is worth a closer examination of the effects
from the COVID-19 pandemic on this sporting sector.
The main aim of this study, therefore, was to explore the impact of the COVID-19
pandemic on the number of endurance and UER events and ﬁnisher numbers as well as
a secondary aim to explore the age and the ﬁnishing marathon times during the ﬁrst few
months of the COVID-19 pandemic (March 2020–October 2020) and compare them to the
same time period pre-COVID-19 pandemic (March 2019–October 2019) to evaluate the
effect COVID-19 has had so far on the endurance and UER event sector. Our hypothesis
was that ﬁnishes and events in endurance and UER would decrease signiﬁcantly during
the COVID-19 pandemic.
2. Materials and Methods
Marathons (distance 42.195 km) were classiﬁed as endurance running events, while
UER events included running distances over marathon distance, timed-events over 6 h
duration, and multi-day and multi-stage events on all running surfaces [14].
Medicina 2021, 57, 52
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2.1. Ethical Procedures
This study was approved by the Institutional Review Board of Kanton St. Gallen,
Switzerland, with a waiver of the requirement for informed consent of the participant as the
study involved the analysis of publicly available data (EKSG 01-06-2010). The study was
conducted in accordance with the recognized ethical standards according to the Declaration
of Helsinki (2013).
2.2. Data Sampling
Data on marathon results were obtained through the publicly available database,
accessible through the website (http://www.marathonguide.com/results/). This database
represents the largest marathon database in the world. Data on UER events were obtained
from a publicly available database, accessible through the website of the Deutsche Ultra-
marathon Vereinigung (DUV) at: https://statistik.d-u-v.org/geteventlist.php. The DUV
contains the largest dataset on UER worldwide and has been frequently evaluated within
the scientiﬁc literature [10,15,16]. Data on race events, race location, race distance, ﬁnishing
numbers, race time, sex, and nationality were, when available and accessible, analyzed for
the time period since the declaration of the COVID-19 pandemic by the WHO in March
2020 [2] until the end of data sampling in October 2020 COVID-19 pandemic period (March
2020–October 2020) and compared to the same time period in the prior year, called the
pre-pandemic period (March 2019–October 2019). In total, 1,192,029 ﬁnishes in 7478 events
were examined.
2.3. Data Analysis
Kolmogorov–Smirnov test was applied to test for normality. Descriptive analysis
was performed and presented as mean and relative (%) frequency and change. Mean
marathon ﬁnishing times and age were also presented with standard deviations (SD). An
independent t-test was used to test the differences between groups and Mann–Whitney test
for not normally distributed data (pre-pandemic vs. pandemic). Statistical signiﬁcance was
set at 5% (p < 0.05). All analyses were carried out using the Python programming language
(Python Software Foundation, https://www.python.org/), Google Colab notebook, and
the Statistical Software for the Social Sciences (IBM SPSS v26. Chicago, IL, USA).
3. Results
Data and results for endurance (marathon) running are available in Table 1. The
number of marathon ﬁnishes according to sexes with monthly breakdowns and percentage
change during the COVID-19 pandemic was compared to the pre-pandemic period and
is shown in Table 1. Monthly breakdowns were used to demonstrate the evolution of the
pandemic, as at different time points, different lockdown restrictions applied throughout
the world. A 10.8-fold drop could be observed in total ﬁnishes pre- to pandemic times,
with almost no ﬁnishes during April/May 2020.
Table 1. Data on number of marathon ﬁnishes according to sexes with monthly breakdowns and percentage change during
the time period of the start of the COVID pandemic (March 2020) until the end of the observation period (October 2020) and
comparison to the same time period pre-COVID in 2019 (March–October 2019).
March
April
May
June
July
August
September
October
Total
Marathon ﬁnishes 2019
45,593
100,898
66,159
28,176
15,633
11,512
26,996
164,062
459,029
Marathon ﬁnishes 2020
32,549
8
0
199
293
1872
4676
3059
42,656 *
Change (%)
−28.6
−100.0
−100.0
−99.3
−98.1
−83.7
−82.7
−98.1
−90.7
Male ﬁnishes 2019
27,812
58,521
41,680
17,187
10,161
8058
17,277
96,797
277,493
Male ﬁnishes 2020
19,204
4
0
137
170
1179
2899
1988
25,582 *
Change (%)
−31.0
−100.0
−100.0
−99.2
−98.3
−85.4
−83.2
−97.9
−93.0
Female ﬁnishes 2019
17,781
42,377
24,479
10,989
5472
3454
9719
67,265
181,536
Female ﬁnishes 2020
13,345
4
0
62
123
693
1777
1071
17,074 *
Change (%)
−24.9
−100.0
−100.0
−99.4
−97.8
−79.9
−81.7
−98.4
−92.8
* p < 0.001.
Medicina 2021, 57, 52
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The number of endurance events dropped signiﬁcantly pre-pandemic to the COVID-
19 pandemic period from 213 to 61 races in the database (p < 0.001), an approximately
3.5-fold drop. Most events were held in United States (pre-pandemic vs. pandemic 61.6%
vs. 72.7%), United Kingdom (10.7% vs. 11.4%), and Canada (10.0% vs. 4.5%), and the
majority of ﬁnishes originated from the United States (pre-pandemic vs. pandemic 72.0%
vs. 93.5%). The ratio between ﬁnishes per event dropped from 2.155 pre-pandemic to
700 ﬁnishers/event during the COVID-19 pandemic (p < 0.001), suggesting that events
were smaller during the pandemic, as less ﬁnishes were observed.
The average age of ﬁnishers pre-pandemic was 47.8 ± 2.0 years and, during the
pandemic, was 43.6 ± 4.3 years (p = 0.02), with female ﬁnishers pre-pandemic 46.0 ±
2.08 years compared to 42.6 ± 2.3 years during the pandemic (p = 0.01) and for male
ﬁnishers 48.9 ± 2.1 years and 43.6 ± 4.3 years (p = 0.02), respectively.
Average marathon ﬁnishing times for men pre-pandemic were 5:18:03 ± 0:16:34 h:min:s
compared to 4:43:08 ± 0:25:08 h:min:s (p = 0.006) pandemic period and for women 5:39:32 ±
0:19:29 h:min:sec compared to 5:14:29 ± 0:26:36 h:min:s (p = 0.02), respectively.
Data for UER ﬁnishes, event distances, and event locations are shown in Tables 2–4.
Data for UER event ﬁnishes, ultra events, and ﬁnishes per event with monthly breakdowns
and percentage change during the COVID pandemic compared to the pre-pandemic period
are shown in Table 2.
Table 2. Data for ultra-endurance event ﬁnishes, ultra events, and ﬁnishes per event with monthly breakdowns and
percentage change during the time period of the start of the COVID pandemic (March 2020) until the end of the observation
period (October 2020) and comparison to the same time period pre-COVID in 2019 (March–October 2019).
March
April
May
June
July
August
September
October
Total
Finishes Ultra 2019
56,741
96,709
74,678
107,273
58,196
54,627
62,147
69,927
580,289
Finishes Ultra 2020
21,310
680
1262
3031
10,124
20,978
27,860
24,810
110,055 *
Change (%)
−62.4
−99.3
−98.3
−97.2
−82.6
−61.6
−55.2
−64.5
−81.0
Ultra events 2019
577
643
775
883
648
707
799
807
5839
Ultra events 2020
205
21
49
92
175
360
447
442
1791 *
Change (%)
−64.5
−96.7
−93.7
−89.6
−73.0
−49.1
−44.1
−45.2
−69.3
Finishes/event 2019
98.3
150.4
96.4
121.5
89.8
77.3
77.8
86.7
99.8
Finishes/event 2020
104.0
32.4
25.8
32.9
57.9
58.3
62.3
56.1
53.7 #
Change (%)
5.7
−78.5
−73.3
−72.9
−35.6
−24.6
−19.9
−35.2
−46.2
* p < 0.001, # p < 0.05.
Table 3. Data for ultra-endurance event ﬁnishes in distance-limited events (50 km, 100 km, and 100 miles) and time-limited
events (6 h, 12 h, and 24 h) with monthly breakdowns and percentage change during the time period of the start of the
COVID pandemic (March 2020) until the end of the observation period (October 2020) and comparison to the same time
period pre-COVID in 2019 (March–October 2019).
Finishes
March
April
May
June
July
August
September
October
Total
50 km 2019
19,289
36,907
17,831
14,433
10,126
10,206
6554
15,424
130,770
50 km 2020
5626
32
126
390
974
3588
4921
5189
20,846 †
Change (%)
−70.8
−99.9
−99.3
−97.3
−90.4
−64.8
−24.9
−66.4
−84.1
100 km 2019
6690
5013
2848
8915
5097
3112
7819
9059
48,553
100 km 2020
250
19
205
149
467
992
3782
1240
7104 #
Change (%)
−96.3
−99.6
−92.8
−98.3
−90.8
−68.1
−51.6
−86.3
−85.4
100 miles 2019
1364
604
1521
3113
1103
3092
2484
3257
16,538
100 miles 2020
129
0
41
34
604
289
1340
1048
3485 †
Change (%)
−90.5
−100.0
−97.3
−98.9
−45.2
−90.7
−46.1
−67.8
−78.9
6 h 2019
4902
4175
3621
2206
2587
1617
8292
3043
30,443
6 h 2020
2374
0
0
282
460
717
936
2917
7686 †
Change (%)
−51.6
−100.0
−100.0
−87.2
−82.2
−55.7
−88.7
−4.1
−74.8
12 h 2019
1329
3825
3477
3673
3406
1586
484
3919
21,699
12 h 2020
143
0
84
246
761
646
1334
1717
4931 †
Change (%)
−89.2
−100.0
−97.6
−93.3
−77.7
−59.3
175.6
−56.2
−77.3
24 h 2019
1753
905
6617
4940
466
3645
865
1910
21,101
24 h 2020
243
0
162
24
1677
1043
1540
895
5584 †
Change (%)
−86.1
−100.0
−97.6
−99.5
259.9
−71.4
78.0
−53.1
−73.5
# p < 0.001, † p < 0.05.
Medicina 2021, 57, 52
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Table 4. Event location (country) of ultra-endurance running events pre- COVID-19 (March 2019-Ocotber 2019) compared
with monthly numbers and total numbers and percentage change to the observation period during the COVID-19 pandemic
(March 2020–October 2020) with listings of the top three event locations (pre-COVD-19: USA, FRA (France), and GBR (Great
Britain); COVID-19 pandemic: USA, GER (Germany), and UK (United Kingdom)), with percentage of all event locations
during that particular month). Further analysis of the location with the greatest change during the observation period is
included (TPE: China Tapei).
Ultra Event
Location
March
April
May
June
July
August
September
October
Total
2019 USA (%)
183 (31.7)
214 (33.3)
210 (27.1)
199 (22.5)
161 (24.8)
216 (30.6)
217 (27.2)
266 (33.0)
1666 (28.5)
2020 USA (%)
84 (41.0)
0 (0.0)
13 (26.5)
29 (31.5)
58 (33.1)
80 (22.2)
126 (28.2)
173 (39.1)
563 (31.4) *
Change (%)
−54.1
−100.0
−93.8
−85.4
−64.0
−63.0
−41.9
−35.0
−66.2
2019 FRA (%)
30 (5.2)
67 (10.4)
65 (8.4)
103 (11.7)
68 (10.5)
35 (5.0)
43 (5.4)
58 (7.2)
469 (8.0)
2020 FRA (%)
15 (7.3)
0 (0.0)
0 (0.0)
0 (0.0)
4 (2.3)
33 (9.2)
25 (5.6)
21 (4.8)
98 (5.5) #
Change (%)
−99.8
N/A
N/A
N/A
−99.6
−99.9
−99.9
−99.9
−100.0
2019 UK (%)
44 (7.6)
28 (4.4)
64 (8.3)
63 (7.1)
50 (7.7)
54 (7.6)
86 (10.8)
32 (4.0)
421 (7.2)
2020 UK (%)
11 (5.4)
0 (0.0)
0 (0.0)
1 (1.1)
3 (1.7)
17 (4.7)
31 (7.0)
36 (8.1)
99 (5.5) *
Change (%)
−99.8
N/A
N/A
−98.4
−99.3
−99.9
−100.0
−99.9
−100.0
2019 GER (%)
30 (5.2)
23 (3.6)
30 (3.9)
50 (5.7)
27 (4.3)
58 (8.2)
37 (4.6)
23 (2.9)
278 (4.8)
2020 GER (%)
5 (2.4)
0 (0.0)
4 (8.2)
11 (12.0)
13 (7.4)
30 (8.3)
29 (6.5)
27 (6.1)
119 (6.6) #
Change (%)
−83.3
−100.0
−86.7
−78.0
−51.9
−48.3
−21.6
17.4
−57.2
2019 TPE (%)
20 (3.5)
24 (3.7)
13 (1.7)
20 (2.3)
12 (1.9)
18 (2.5)
15 (1.9)
16 (2.0)
138 (2.4)
2020 TPE (%)
10 (4.9)
19 (90.5)
17 (34.7)
12 (13.0)
12 (6.9)
19 (5.3)
14 (3.1)
6 (1.4)
109 (6.1) #
Change (%)
−50.0
−20.8
30.8
−40.0
0.0
5.6
−6.7
−62.5
−21.0
* p < 0.001, # p < 0.05.
A 5.3-fold decrease in UER ﬁnishes can be observed during the COVID-19 pandemic,
and a 3.3-fold decrease in UER events. Finishes per events also decreased from 99.8 to
53.7 ﬁnishes/event, a 1.9-fold decrease, demonstrating that events were smaller with
fewer ﬁnishes.
The 50 km distance remained the most popular UER distance, and data for UER event
ﬁnishes in distance-limited events (50 km, 100 km, and 100 miles) and time-limited events
(6 h, 12 h, and 24 h) with monthly breakdowns and percentage change during the COVID
pandemic compared to pre-pandemic period are shown in Table 3.
UER event locations (countries) during the COVID-19 pandemic are compared monthly
to the pre-pandemic period and shown in Table 4. The three top event locations pre-
pandemic were USA, France, and United Kingdom and during the COVID-19 pandemic
were USA, Germany, and United Kingdom. For further comparison and illustration, the
UER events of China Tapei are shown, as this location showed, in contrast to others, a
relative increase during the COVID-19 pandemic, especially in April 2020 with over 90% of
events hosted in this location.
Additionally, UER event numbers and performances from 2018 (6708 vs. 609,847)
increased to 2019 (7468 vs. 671,738), increases of 11.3% and 10.1%, respectively.
4. Discussion
Running is one of the most popular sports worldwide, with endurance and UER
showing important increases in participation and ﬁnishes over the last few decades [13,14].
Since the onset of the COVID-19 pandemic in March 2020 [2], many sporting events were
canceled or postponed, but the impact of the pandemic on endurance and UER has not
been examined thus far.
The aim of the study was, therefore, to explore the impact of the COVID-19 pandemic
on endurance and UER events and participation and the implications of the endurance and
UER sector as a whole. We hypothesized that, during the COVID-19 pandemic, ﬁnishing
numbers and events would decrease signiﬁcantly when compared to the same time period
in the preceding year in pre-pandemic times.
The main ﬁndings of our study were: (i) ﬁnishes in endurance races decreased signiﬁ-
cantly during the pandemic, with an almost 11-fold decrease; (ii) event numbers decreased
signiﬁcantly in endurance events during the pandemic, with almost no activity during
April/May 2020; ﬁnishes/event ratio decreased as well, suggesting that events were
smaller during the pandemic, as less ﬁnishes were observed; (iii) average age of endurance
Medicina 2021, 57, 52
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ﬁnishers decreased signiﬁcantly during the pandemic, as did the marathon ﬁnishing times;
(iv) ﬁnishes in UER decreased signiﬁcantly during the pandemic, with an over 5-fold
decrease, with the biggest decrease in April/May 2020; (v) event numbers and locations in
UER decreased signiﬁcantly, with a proportional increase in events in China Tapei during
the pandemic, especially in April 2020; (vi) the 50 km event remained the most popular
distance based UER event and the 6 h the most popular time-limited event, both showing a
signiﬁcant decline during the pandemic.
As with other sports and sporting events during the global crisis, many endurances
and UER were postponed, canceled, or held virtually due the continued uncertainty of
the virus’s spread and the potential risk of spreading the virus through congregation of
runners. From personal experience, a number of events were held virtually, however, we
are unaware of any available data sets on a larger scale for analysis and comparison.
Our data show the effect of the COVID-19 pandemic since it was ﬁrst declared on
11 March 2020 [2] on endurance and UER running. We observed a signiﬁcant decrease in
ﬁnishes and event numbers in endurance and UER, especially in the ﬁrst two full months
after the pandemic was declared (April/May 2020) with little to no activity in endurance
and UER during this time. This is something that could be expected, as with national and
local lockdowns, restrictions, and bans on travel, very little movement occurred during
these time periods [1,3]. Overall ﬁnishes in endurance running decreased almost 11-fold,
while UER ﬁnishes decreased 5-fold during the observation period of the pandemic. One
explanation may be that endurance running is generally more popular than UER and that
the UER community tends to be smaller. Perhaps participation continued in smaller, more
local races, as demonstrated by our data that showed that approximately 50 ﬁnishes/event
in UER were observed compared to 700 ﬁnishes/endurance event, although the percentage
drop in events for endurance and UER were very similar. Additionally, the number of
events in the endurance running database was comparatively smaller than for UER events,
which further may add to this. UER events and ﬁnishing numbers have been increasing
over the last 20 years [12,13], and this can similarly be observed when comparing UER
event numbers and performances from 2018 to 2019. A further increase in 2020 could have
been expected if not for the COVID-19 pandemic.
Another interesting observation in endurance events is that the average age of marathon
ﬁnishers decreased during the pandemic, as did the average marathon ﬁnishing times. The
reason for this may be, that more experienced runners kept participating in marathons
during the COVID-19 pandemic, whilst more amateur runners stayed at home, similarly
to older participants, that present a higher risk population of developing more severe
symptoms of COVID-19.
In UER, race distances of 50 km are generally the most popular UER distances [13]; this
was also observed during the pandemic, however, with a signiﬁcant decrease compared to
pre-pandemic levels. The same could be observed in all other distance limited events (100
km and 100 miles) and time limited UER (6 h, 12 h, and 24 h). Since August 2020, numbers
of ﬁnishes have increased notably, however are still lagging behind considerably compared
to pre-pandemic levels.
Running events can have positive economic effects with short and long term economic
consequences [17], whereas cancelation may have a detrimental effect, as exempliﬁed
by the cancelation of the Two Oceans Marathon and the New York Marathon [4,8]. The
cancelation of the 2020 Two Oceans Marathon in South Africa reported an approximate
loss of revenue of around 2 million dollars [4]. Similarly, the New York City marathon
incurred signiﬁcant losses when canceled due to the effects of a devastating natural disaster
(hurricane Sandy) with estimated losses of charitable donations of 36.1 million US dollars
and an total estimated economic impact of the race of approximately 415 million US
dollars in 2014 [8]. Additionally important to note is that running events can have positive
economic effects during the COVID-19 pandemic, as sporting events can create positive
publicity in sending out the signal that the city or the country is open for business and
thus can create economic growth [17]. This was the case of China Tapei that was the most
Medicina 2021, 57, 52
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popular UER event location in April/May 2020. Whether this also created additional
economic growth is not known.
However, it is also important to note that running poses an extremely low risk of
COVID-19 transmission, with only one reported case among 571,401 athletes and 98,035
ofﬁcials and staff that took part in 787 races and track meetings in Japan since July 2020 [18].
All events were held without spectators, and speciﬁc safety measures were introduced,
which may potentially allow running activities to resume with appropriate safety proto-
cols [18]. Such tools have been developed by the WHO that provides a risk assessment tool
for sporting and mass gathering events during the COVID-19 pandemic, considering spe-
ciﬁc action plans and risk mitigation strategies [19]. These strategies may help in delaying
the spread of an outbreak [20] and may be useful tools in the decision-making processes of
hosting an event [3].
Our results show the devastating effects COVID-19 had on endurance and UER. It
is necessary to examine the possibility of returning to pre-COVID-19 levels, as a whole
branch of the sporting industry is dependent on this activity. With risk assessment tools,
mitigation strategies, and strict safety protocols, a gradual return to endurance and UER
may be possible, especially considering the extremely low risk outdoor running poses for
contracting COVID-19. However, a return to pre-pandemic levels any time soon remains
unlikely until the time an effective drug treatment or vaccine becomes available [20].
Further studies examining the economic effect of the COVID-19 pandemic on en-
durance and UER may be useful to estimate the potential loss to the industry in addition
to examining the impact on health. Similarly, examining the demographics and the per-
formance times further and over a longer time period may provide additional important
information on how COVID-19 has impacted running and UER.
Limitations
Of the two publicly available databases used for this analysis, the marathon results
database (http://www.marathonguide.com/results/) is the largest database of marathon
results in the world, fully searchable by name, place, or time. However, the majority of data
pertain to races held in the United States, Canada, Australia, and New Zealand, and we
recognize this as a limiting factor for applicability on races worldwide. The DUV database
(https://statistik.d-u-v.org/geteventlist.php) is the largest database worldwide of UER
events and has been widely used in the past in the scientiﬁc literature [10,15,21]. However,
as with any large database, not all results may be complete, and we recognize that this
as a limiting factor. Nevertheless, the aim of the study was to examine the impact of
COVID-19 on endurance and UER, and both databases provide a sufﬁciently sizable data
sample for analyses. Examining and comparing marathon ﬁnishing times pre-pandemic
to pandemic provides some interesting insights, however, comparing several different
events with different ambient conditions and race proﬁles has its limitations and needs to
be interpreted with care.
5. Conclusions
Endurance and UER have seen a signiﬁcant decrease in the number of ﬁnishes and
events during the COVID-19 pandemic with a devastating effect on the sporting industry.
It is unlikely that running activities will return to pre-pandemic levels any time soon, and
mitigation strategies and safety protocols should be established until the time an effective
drug treatment or vaccine becomes available. Future studies might analyze the economic
impact COVID-19 has had on the endurance and UER industry as a whole.
Author Contributions: Conceptualization, V.S. and B.K.; methodology, V.S.; software, D.V.; valida-
tion, D.V.; formal analysis, D.V.; investigation, V.S.; resources, E.V.; data curation, E.V.; writing—
original draft preparation, V.S.; writing—review and editing, T.R., V.S., D.V., B.K. All authors have
read and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Medicina 2021, 57, 52
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Institutional Review Board Statement: This study was approved by the Institutional Review Board
of Kanton St. Gallen, Switzerland, with a waiver of the requirement for informed consent of the
participant as the study involved the analysis of publicly available data (EKSG 01-06-2010). The study
was conducted in accordance with the recognized ethical standards according to the Declaration of
Helsinki (2013).
Informed Consent Statement: Not applicable.
Data Availability Statement: Not applicable.
Conﬂicts of Interest: The authors declare no conﬂict of interest.
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The Impact of the COVID-19 Pandemic on Endurance and Ultra-Endurance Running.
Scheer, Volker,Valero, David,Villiger, Elias,Rosemann, Thomas,Knechtle, Beat