BACKGROUND: There are no data relating symptoms of an acute respiratory illness (ARI) in general, and COVID-19 specifically, to return to play (RTP). OBJECTIVE: To determine if ARI symptoms are associated with more prolonged RTP, and if days to RTP and symptoms (number, type, duration and severity) differ in athletes with COVID-19 versus athletes with other ARI. DESIGN: Cross-sectional descriptive study. SETTING: Online survey. PARTICIPANTS: Athletes with confirmed/suspected COVID-19 (ARI) (n=45) and athletes with other ARI (ARI) (n=39). METHODS: Participants recorded days to RTP and completed an online survey detailing ARI symptoms (number, type, severity and duration) in three categories: ', ' and '. We report the association between symptoms and RTP (% chance over 40 days) and compare the days to RTP and symptoms (number, type, duration and severity) in ARI versus ARI subgroups. RESULTS: The symptom cluster associated with more prolonged RTP (lower chance over 40 days; %) (univariate analysis) was ' (75%; p<0.0001), '' (65%; p=0.004), '' (64%; p=0.004), '' (56%; p=0.006), ' (51%; p=0.009), '' (48%; p=0.033), '' (48%; p=0.022) and '' (47%; p=0.022). '' remained associated with prolonged RTP (p=0.0002) in a multiple model. Compared with ARI, the ARI subgroup had more severe disease (greater number, more severe symptoms) and more days to RTP (p=0.0043). CONCLUSION: Symptom clusters may be used by sport and exercise physicians to assist decision making for RTP in athletes with ARI (including COVID-19).