Context: As sports reinitiate around the country, 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 utilized by youth soccer organizations. Design: Retrospective cohort. Participants: Youth soccer club directors throughout the United States. Main Outcome Measures: Surveys were completed in late August 2020 regarding phase of return to soccer (individual only, group non-contact, group contact), date of reinitiation, number of players, cases of COVID-19, and risk reduction procedures being implemented. Case and incidence rates were compared to national pediatric data and county data from the prior 10 weeks. A negative binomial regression model was developed to predict club COVID-19 cases with local incidence rate and phase of return as covariates and the log of club player-days as an offset. Results: 124 respondents had reinitiated soccer, representing 91,007 players with a median duration of 73 days (IQR: 53-83 days) since restarting. Of the 119 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 US (254 v. 477 cases per 100,000; incidence rate ratio [IRR]=0.511, 95% CI = [0.40-0.57], p<0.001) and the general population from the counties where data was available (268 v. 864 cases per 100,000; IRR=0.202 [0.19-0.21], p<0.001). After adjusting for local COVID-19 incidence, there was no relationship between club COVID-19 incidence and phase of return (non-contact: b=0.35±0.67, p=0.61; contact: b=0.18±0.67, p=0.79). Soccer clubs reported utilizing a median of 8 (IQR: 6-10) risk reduction procedures. Conclusions: The incidence of COVID-19 among youth soccer athletes is relatively low when compared to the background incidence among children in the United States in summer of 2020. No relationship was identified between club COVID-19 incidence and phase of return to soccer.
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