You're right about the numbers but football is still king in Western PA. It's still shocking the number of blue chip recruits that come out of Pittsburgh and surrounding counties.
Population collapse is really going to be a major hurdle for the entire country as most places have been able to somewhat replace their declining native populations with immigrant populations, but there are very few immigrants in Pittsburgh. I believe it has the fewest non-student immigrants of any major metro area in the country.
One of my largest clients was in Pittsburgh, so I actually spent at least a week every month there from 2014-2020. My apartment had waitlisted availability until the pandemic hit and then it was completely empty (with the exception of a ballet school renting out entire floors for dorms because they wanted to provide social distancing). As much as I hated having an apartment amongst a bunch of 22 year old ballerinas, it was really odd. I was the only person on my floor.
It's a great city but it feels like it still has some readjustment pains coming its way.