COVID-19 and lockdown strategies may affect mental health and addictive behavior differently in the population, and elite athletes are among the professions clearly affected by the pandemic . This study in top elite athletes aimed to study current perceived psychological influence from COVID-19 and symptoms of depression, anxiety and changes in alcohol drinking, gambling behavior and problem gambling in the midst of the COVID-19 lockdown . This web survey included athletes in top leagues of soccer, ice hockey and handball in Sweden (N = 327 , 62% men). A total of 66% and 51% were worried about the future of their sport or about their own future in sports, respectively . Feeling worse psychologically during the pandemic was common (72% of women , 40% of men, <0.001); depression criteria were endorsed by 19% of women and three percent of men (< 0.001); anxiety criteria by 20% of women and five percent of men (< 0.001). Reporting increased gambling during the pandemic was associated with gambling problem severity . Moderate-risk or problem gambling was seen in 10% of men and none of the women (< 0.001). Depression and anxiety were associated with feeling worse during the COVID-19 pandemic and with concern over one's own sports future . In conclusion, COVID-19-related distress is common in elite athletes and associated with mental health symptoms . Gambling increase during the pandemic was rare, but related to gambling problems, which were common in male athletes . The calls for increased focus on COVID-19-related concerns in athletes and on problem gambling in male athletes.