Djokovic threw up on court at Arthur Ashe Stadium multiple times during a Sunday night match that stretched past four and a half hours. He used an inhaler between points, took tablets, and stretched a cramping left foot after nearly every rally in the closing sets. As Navone moved 4-1 clear in the decider, the 39-year-old broke down in tears while the crowd tried to lift him.

The 24-time major champion, seeded fourth in New York, lost 7-6 (5), 5-7, 4-6, 6-2, 6-1 in 4 hours and 36 minutes to the Argentine ranked No. 49 in the world. He piled up 70 unforced errors and needed a medical timeout between the fourth and fifth sets for a back massage and medication.

“I pretty much despised every moment”

His post-match verdict was blunt.

“I didn’t enjoy myself. I think it was obvious that it was an awful feeling on the court for me,” Djokovic told reporters.

Read also: UEFA goes after FIFA’s billions after failed World Cup deal

The stomach trouble was not new.

“It’s something that I’ve been carrying, unfortunately, pretty much every match this year: vomiting, throwing up,” Djokovic said in New York.

A 20-year first-round streak ends

The defeat was Djokovic’s first opening-round loss at the US Open, and his first at any Grand Slam since the 2006 Australian Open, when he lost to Paul Goldstein. It snapped a run of 78 consecutive first-round wins at majors.

It also carried an era-defining footnote. For the first time since the 2003 French Open, a men’s Grand Slam will reach its second round without Djokovic, Roger Federer or Rafael Nadal in the draw.

Read also: UEFA targets secret FIFA files as Infantino crisis escalates

The biggest win of Navone’s career

For the 25-year-old Navone, the win was the biggest of his career.

“[It] was very tough for me because you are playing with the ‘GOAT’ on this court,” Navone said. “This is an amazing court and the biggest stage. I’m very happy.”

Djokovic’s exit ends the four-time US Open champion’s tournament on the first night of the event and blows open the top half of the men’s draw. It was his second straight first-round loss after also exiting the Cincinnati Open earlier this month following his Wimbledon semifinal loss to Jannik Sinner.

Read also: Video released: Body camera captures the moment 49ers owner was arrested in prostitution sting

Read also: Wimbledon champion Vondrousova appeals four-year doping ban: 'I reached breaking point'