Change in quality of life, sleep, and physical activity during COVID-19: A longitudinal study of adolescent athletes

Context The abrupt cessation of school and sport participation during the COVID-19 pandemic may have negative implications for adolescent mental health. Objective (1) To compare mental, physical, and social health and behaviors during pandemic-related stay-at-home mandates with the same measures collected 1–2 years prior. (2) To assess the relationship of physical activity and sleep during the pandemic with anxiety, fatigue, and peer relationship changes between assessment timepoints. Design Prospective cohort study, repeated-measures Setting Pediatric sports medicine center Participants High school athletes (n=39; 16.2±0.9 years of age; 64% female) Main Outcome Measures Patient Reported Outcome Measurement System (PROMIS) anxiety, fatigue, and peer relationships short forms and the Pittsburgh Sleep Quality Index (PSQI) were completed at two timepoints (initial assessment: May 2018 or 2019; follow-up assessment: May/June 2020). Physical activity frequency and duration, and frequency of interaction with other individuals (family, peers, sport coaches, etc.), were self-reported at follow-up assessment for the two weeks prior to school/sport closure and the two weeks prior to questionnaire completion. Results Higher levels of anxiety (5.5±4.0 vs. 3.6±3.4; p=0.003) and fatigue (5.4±3.7 vs. 2.3±2.5; p Conclusions Mental and physical health declined during stay-at-home mandates, compared to assessments 1–2 years earlier. Physical activity behaviors and sources of social interaction underwent significant changes following school and sport cessation. Quality sleep may provide some protection against declining adolescent mental health during the pandemic, although this relationship requires further investigation.