Coco Gauff advanced to the round of 16 at the Madrid Open on Sunday despite battling a stomach virus that has affected several players in the tournament. The American overcame Sorana Cirstea in a three-set match, winning 4-6, 7-5, 6-1 after two hours and 21 minutes. During the match, Gauff was visibly unwell, even vomiting courtside and requesting a medical timeout in the latter stages before completing the victory.

The illness has impacted multiple competitors in Madrid this week, including world number one Iga Swiatek, who retired from her match against Ann Li on Saturday, and Marin Cilic, who withdrew before his second-round match with Joao Fonseca on Friday. Liudmila Samsonova also cited illness and pulled out of her scheduled third-round encounter with Linda Noskova on Sunday.

Gauff, a two-time Grand Slam champion and last year’s runner-up to Aryna Sabalenka in Madrid, acknowledged the difficulty of finishing the match while feeling unwell. “I was just trying to finish the match and one point turned into another,” she said. “I think I got what everybody else is having here in Madrid, unfortunately. So, I’m just going to try to push through for tomorrow.” She credited medication given by the medical team for helping control her nausea, though she remained fatigued.

With the win, Gauff set up a last-16 match against Noskova. She also faces pressure in the coming weeks, as she has 3,300 ranking points to defend on clay from Madrid ahead of her title defense at Roland Garros in early June.

Elsewhere in Madrid, Italian player Jannik Sinner continued his winning streak with a 6-2, 6-3 victory over Danish qualifier Elmer Moller. Sinner extended his impressive run to 19 consecutive wins, including 24 straight victories at the Masters 1000 level. He will next face either Cameron Norrie or Thiago Agustin Tirante.

Another Italian, Lorenzo Musetti, defeated Dutch 29th seed Tallon Griekspoor 6-4, 7-5 to progress to the last 16, where he will meet Czech 11th seed Jiri Lehecka.

Among other results, American fifth seed Jessica Pegula, riding a six-match winning streak, was upset by Ukraine’s Marta Kostyuk 6-1, 6-4. Kostyuk recently won a clay title in Rouen, while Pegula had just defended her Charleston title on green clay earlier this month.

The ongoing outbreak of illness at the Madrid Open has raised concerns over player health, with several withdrawals disrupting the tournament draw as the event moves deeper into the competition.