Abstract
In the COVID-19 era, the prevalence of wearing face masks by athletes while exercising and examination of reasons for not wearing them and of association of maximum ambient temperature on performance while wearing mask were investigated by a self-administered web-based questionnaire. Primary data was correlated with secondary data such as average temperature, which were obtained from open sources. Athletes (n = 633, 84.7% male, 45.8% 20-29 years of age) from 188 countries participated in the survey conducted between June and July 2020. The majority of athletes (70.8%) wore masks while exercising and 66.8% of athletes reported mask wearing adversely affected their performance, in particular among all users of N95, FFP2 or equivalent mask and 90.9% of those wearing surgical mask. Adverse performance is significantly associated with highest ambient temperature in the respective country (p-value <0.001). In conclusion, wearing a face mask during the COVID-19 pandemic adversely impacted high-intensity exercise performance in athletes due to discomfort and restriction in breathing, and high ambient temperature was also a negative factor.