The COVID-19 pandemic and physical activity

High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation

Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with patient characteristics, disease severity and cardiac dysfunction. We objectively assessed PA, sedentary behaviour and sleep duration for 24 h/day during 8 days at 3-6 months after COVID-19 hospitalisation. PA and sedentary time were compared across pre-defined subgroups based on patient and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram at 3-6 months post-hospitalisation and persistence of symptoms post-discharge. PA and sedentary behaviour were assessed in 37 patients (60 ± 10 years old; 78% male). Patients spent 4.2 [3.2; 5.3] h/day light-intensity PA and 1.0 [0.8; 1.4] h/day moderate-to-vigorous intensity PA. Time spent sitting was 9.8 [8.7; 11.2] h/day, which was accumulated in 6 [5; 7] prolonged sitting bouts (≥30 min) and 41 [32; 48] short sitting bouts (<30 min). No differences in PA and sedentary behaviour were found across subgroups, but sleep duration was higher in patients with versus without persistent symptoms (9.1 vs. 8.3 h/day, p = 0.02). Taken together, high levels of sedentary time are common at 3-6 months after COVID-19 hospitalisation, whilst PA and sedentary behaviour are not impacted by patient or disease characteristics.

Is Being Physically Active Enough or Do People with Parkinson's Disease Need Structured Supervised Exercise? Lessons Learned from COVID-19

Social isolation imposed by the COVID-19 pandemic negatively impacted people’s lifestyles and daily activities. In this work we compared pre- and post-pandemic clinical outcomes in people with Parkinson’s disease, to assess differences according to the type of behaviour and exercise habits adopted by participants. After two months of COVID-19 lockdown, we assessed: changes in exercise behaviour; motor and non-motor aspects of daily life experiences (MDS-UPDRS I & II); activities of daily living (The Schwab & England scale); quality of life (Parkinson Disease Questionnaire); sleep (Parkinson Disease Sleep Scale); falls; and Clinical Global Impression Change. Twenty-seven individuals aged between 57 and 92 years old participated; from these, ten individuals (37%) completely interrupted physical activities, while seventeen (63%) maintained some level of active lifestyle. Regardless of whether they remained active or not, all participants perceived a significant worsening of their clinical condition, reporting an increase in difficulties completing daily activities or chores (37%) and worsening of their health condition (51.8%). The quantifiable influence of exercise habits was borderline for the group who kept active. The active group seem to have a better self-perception of their health condition, although it was not enough to show a clear benefit. People with Parkinson’s disease should be informed that being physically active may not be enough and more structured exercise could be needed.

Association between the Physical Activity Behavioral Profile and Sedentary Time with Subjective Well-Being and Mental Health in Chilean University Students during the COVID-19 Pandemic

OBJECTIVE

To analyze the association between the behavioral profile of physical activity and sedentary time with subjective well-being and mental health in university students during the COVID-19 pandemic in Chile.

METHODS

Cross-sectional study in a voluntary sample of 469 university students (22.4 ± 0.19 years; 66% women). According to students' self-reports of physical activity and sedentary time, four behavioral profiles were created to investigate their association with subjective well-being and mental health using one-factor ANOVA that was adjusted to a multifactorial model.

RESULTS

The physically inactive and sedentary behavior profile presents the lowest levels of subjective well-being (p < 0.001), positive affective experiences (p < 0.001) and general mental health (p = 0.001). When adjusting for confounding variables, it was observed that the physically active and non-sedentary profile was associated with better general mental health (p < 0.01) in contrast to those who are physically active and sedentary.

CONCLUSIONS

Chilean university students with a physically inactive and sedentary profile during the pandemic presented worse well-being and mental health, with a sedentary lifestyle being one of the variables that most affects the mental health of these students. Therefore, measures should be implemented to encourage this population to maintain adequate levels of physical activity and reduce sedentary times.

Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes

Objective

To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with a confirmed diagnosis of COVID-19.

Methods

Directly measured physical activity data from 65 361 adult patients with a COVID-19 diagnosis from 19 March 2020 to 30 June 2021, were grouped by activity level: low (<60 min/week), moderate (60–149 min/week) and high activity (≥150 min/week). The association of physical activity levels and the risk of adverse outcomes was analysed using modified Poisson regression. We accounted for demographics and comorbidities including conditions known to influence COVID-19 outcomes, as well as patient complexity as measured by the Johns Hopkins Adjusted Clinical Group system. The regression approach was further validated with a Bayesian network model built off a directed acyclic graph.

Results

High physical activity was associated with lower rates of hospitalisation (risk ratio, RR 0.66, 95% CI 0.63 to 0.70), ICU admission (RR 0.59, 95% CI 0.52 to 0.66), ventilation (RR 0.55, 95% CI 0.47 to 0.64) and death (RR 0.58, 95% CI 0.50 to 0.68) due to COVID-19 than those who engaged in low physical activity. Moderate physical activity also was associated with lower rates of hospitalisation (RR 0.87, 95% CI 0.82 to 0.91), admission to ICU (RR 0.80, 95% CI 0.71 to 0.89), ventilation (RR 0.73, 95% CI 0.62 to 0.84) and death (RR 0.79, 95% CI 0.69 to 0.91).

Conclusions

Adults with high and moderate physical activity levels had significantly better outcomes than those with low activity when contracting COVID-19. The apparent protective effects of regular physical activity extended to those with concomitant chronic medical conditions.

How do Vaccinators Experience the Pandemic? Lifestyle Behaviors in a Sample of Italian Public Health Workers during the COVID-19 Era

Public health workers (PHWs) have experienced substantial workload changes because of their role in managing measures to limit the spread of COVID-19. The study’s aim was to assess lifestyle changes in Italian PHWs during the pandemic. PHWs attending an annual meeting completed an anonymous questionnaire assessing their sociodemographic and behavioral characteristics and lifestyle changes during the pandemic. A total of 1000 questionnaires were completed. Most participants (63.5% women, mean age 40 ± 13.1 years) were of normal weight (61.5%), non-smokers (81.9%), had a total screen time of ≥5 h/day (83.1%), and slept at least 6 h/night (88.7%). Approximately one-third consumed sweet foods every day (30%) and did not engage in physical activity (34.6%). Current sweet food consumption, physical activity, and sleep were associated with changes in these behaviors in the last 2 years (Tau-b = 0.155; Tau-b = −0.175; Tau-b = −0.276, respectively, p < 0.001). An increase in remote working was associated with worse sleep (odds ratio (OR) 2.065, 95% confidence interval (CI) 1.482–2.877) and diet (OR 1.982, 95% CI 1.385–2.838), and increased tablet/PC use (OR 3.314, 95% CI 2.358–4.656). Health promotion measures are needed to support the adoption of healthy lifestyles in this population during the current pandemic.

An Assessment of Various Challenges Perceived by Dental Students amidst the COVID-19 Pandemic: A Digital Questionnaire Study

The objective of our study was to evaluate dental students’ perception of the challenges faced during the COVID-19 pandemic related to their clinical work, education, performance, online examinations, psychological health, and teamwork. A validated online questionnaire consisting of closed ended questions was sent to all the undergraduate dental students at our institute. Data were collected and analyzed statistically using a chi-square test to compare responses of male with female and junior with senior students. A total of 317 undergraduate dental students (N = 317) participated in this cross-sectional study. The most common challenges perceived by the participants were related to their exam duration (77.3%), patient availability (66.9%), difficulty in understanding online lectures (58.4%), and a fear of losing grades (57.4%). Participants reported that the COVID-19 pandemic affected their performance in the courses (75.4%), teamwork (72.2%), educational aspects (67.5%), and psychological health (51.1%). A significantly greater proportion of female students reported the adverse effects of COVID-19 on their psychological health than male students (p = 0.031). Senior students perceived the negative impact of COVID-19 on teamwork significantly more than the junior students (p = 0.004). The majority of students reported challenges during the COVID-19 pandemic. Female students and senior students perceived more challenges than their counterparts. Future studies from other institutes of this region are recommended to establish a clearer picture of COVID-19 related challenges faced by dental students.

Protective Effects of Exercise Become Especially Important for the Aging Immune System in The Covid-19 Era

Aging is a complex, multietiological process and a major risk factor for most non-genetic, chronic diseases including geriatric syndromes that negatively affect healthspan and longevity. In the scenario of "healthy or good aging", especially during the COVID-19 era, the proper implementation of exercise as "adjuvant" or "polypill" to improve disease-related symptoms and comorbidities in the general population is a top priority. However, there is still a gap concerning studies analyzing influence of exercise training to immune system in older people. Therefore, the aim of this review is to provide a brief summary of well-established findings in exercise immunology and immunogerontology, but with a focus on the main exercise-induced mechanisms associated with aging of the immune system (immunosenescence). The scientific data strongly supports the notion that regular exercise as a low-cost and non-pharmacological treatment approach, when adjusted on an individual basis in elderly, induce multiple rejuvenating mechanisms: (1) affects the telomere-length dynamics (a "telo-protective" effect), (2) promote short- and long-term anti-inflammatory effects (via e.g., triggering the anti-inflammatory phenotype), 3) stimulates the adaptive immune system (e.g., helps to offset diminished adaptive responses) and in parallel inhibits the accelerated immunosenescence process, (4) increases post-vaccination immune responses, and (5) possibly extends both healthspan and lifespan.

COVID-19 and Physical Activity Behaviour in People with Neurological Diseases: A Systematic Review

The COVID-19 pandemic has led to a radical lifestyle change, which may unintendedly change physical activity levels. We aimed to perform a systematic review to investigate the physical activity changes in people with neurological diseases, and to examine the relationship between physical activity and disease symptoms, and psychosocial factors. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of the literature across five databases (PubMed, CINAHL, Web of Science, SCOPUS, and Cochrane Library) was carried out using the keywords relating to COVID-19, physical activity, sedentary behaviour, exercise, and the name of the neurological diseases. The systematic search was updated on 4 February 2021 with the same keywords. Fourteen studies (n = 7662 persons with neurological diseases, n = 1663 healthy controls) were eligible for this review. The study populations were Parkinson disease (n = 7), dementia (n = 1), multiple sclerosis (n = 1), spinal cord injury (n = 1), hereditary spastic paraplegia (n = 1), neuromuscular diseases (n = 1), Charcot-Marie-Tooth neuropathy (n = 1), and epilepsy (n = 1). Thirteen studies reported a decreased physical activity level, one study reported a high interruption rate of physiotherapy/rehabilitation. Furthermore, the physical activity reduction was associated with worse disease symptoms, depression, perceived health, and mental and physical components of quality of life. The COVID-19 pandemic has a negative impact on the physical activity levels of people with neurological diseases, and this change was related to the worsening of disease symptoms and psychosocial factors. Registration number A protocol of the review was registered with the PROSPERO database (CRD42020207676).

Supplementary Information

The online version contains supplementary material available at 10.1007/s10882-022-09836-x.

Biopsychosocial Factors Predicting Pain Among Individuals Experiencing the Novel Coronavirus Disease (COVID-19)

BACKGROUND

Pain is one of the most common symptoms of novel coronavirus disease (COVID-19). Being both a physical and a psychological experience, pain is affected by many factors, including biological, psychological, and social rather than a single variable.

AIMS

To determine the effects of biological, psychological, and social factors on pain level among participants experiencing with the COVID-19.

DESIGN

A web-based, retrospective, and descriptive study SETTING: Social media sources such as Facebook, WhatsApp, Instagram, and E-mail PARTICIPANTS: One hundred forty-nine participants were included.

METHODS

Data were collected based on the biopsychosocial model. Pain level was evaluated using the visual analog scale (VAS). The data were analyzed using descriptive, correlational statistics, and structural equation modeling.

RESULTS

The mean age of participants was 32.87 (SD = 11.32) years. The VAS scores were associated with gender (Z = -2.103, p = .035), and chronic disease status (Z = 3.001, p = .003), and the Chalder Fatigue Scale total score (β = 0.718, p < .001) associated with biological factors. The Coronavirus Anxiety Scale scores among psychological factors showed a direct impact on the VAS scores (β = 0.583, p < .001). The Patterns of Activity Measure-Pain total score examined within social factors directly affected the VAS score. The VAS score did not correlate with age, smoking status, hospitalization status, respiratory support, marital status, education level, employment, and income status.

CONCLUSIONS

The pain level in COVID-19 participants was determined by biological, psychological, and social factors. Females and participants with chronic illness, anxiety, fatigue, and low physical activity were found to experience high levels of pain. Education and counseling programs for pain management should be comprehensively structured and include anxiety reduction programs, and fatigue management.

Physical activity levels and mental health burden of healthcare workers during COVID‐19 lockdown

The outbreak of COVID-19 has precipitated international lockdown measures to curb disease transmissions. The closure of public activity spaces as well as changes in pandemic workload may disrupt healthcare workers' physical activity and self-care routines. We sought to examine the association between physical activity levels and mental health burden of healthcare workers during the COVID-19 lockdown in Singapore. This cross-sectional study comprised of an multidomain survey that was administered digitally to 707 healthcare workers between 17 May and 18 June 2020. Exercise frequency, duration and intensity of these healthcare workers had reduced significantly during the lockdown compared to pre-lockdown. 25.3%, 37.2%, and 11.9% had screened positive for moderate-to-extremely-severe depression, anxiety and stress respectively. Reductions in exercise duration was a significant risk factor for mild stress and moderate-to-severe depression while increase in exercise frequency was found to be a protective factor against depressed mood. Our study revealed that a short-term reduction in physical activity levels during lockdown was associated with poorer psychological outcomes. Given the protection that exercise confers on depression, physical activity should be promoted at the workplace and at home to support healthcare workers to cope through this protracted health crisis.

Participation in physical activity decreased more in people with rheumatoid arthritis than the general population during the COVID-19 lockdown: a cross-sectional study

The COVID-19 pandemic and social distancing restrictions have significantly reduced population-wide physical activity (PA) levels. However, the impact of the pandemic and relevant restrictions on PA participation, and any potential barriers to it, in people with rheumatoid arthritis (RA) are not clear. Furthermore, we are unsure if any such PA changes have affected their body weight, mental wellbeing, and/or quality of life (QoL). Thus, the aim of this study was to examine the impact of the lockdown on PA participation in people with RA, versus people without RA. Participants (n = 128; RA = 27, non-RA = 101) completed a self-administered online survey, which included questions on PA, body weight, mental wellbeing and QoL. PA participation during lockdown was significantly lower among RA versus non-RA participants (p < 0.001). Additionally, a similar profile of results was found where more RA participants vs non-RA participants reported reduced habitual PA (59% vs 33%) and increased body weight (59% vs 35%). Mental wellbeing scores were similarly low in both groups during lockdown (RA: 20.8 ± 4.2; non-RA: 22.2 ± 3.4, p = 0.080). Matched group comparisons identified similar trends to full sample analyses. In the first months of the lockdown, more people with RA reported decreased PA participation and increased body weight than their non-RA counterparts. Access to exercise equipment and facilities appears to be the main cause for these results. Looking beyond COVID-19, specific PA promotion for people with RA will be required to prevent a pandemic of inactivity.

Changes in Physical Activity and the Occurrence of Specific Symptoms of "Long-COVID Syndrome" in Men Aged 18-25

The aim of this study was to assess the occurrence of non-specific symptoms of “long-COVID syndrome” depending on the physical activity undertaken resulting from the imposed forms of study (distance learning–contact learning); 136 men aged 21.5 ± 1.58 from universities educating students of medical faculties were examined. The difference between the universities was mainly due to the nature of the classes undertaken (classes remotely-hybrid form) in the period from March 2020 to February 2021. Among the respondents, 17% in Group I and 16% in Group II were infected with the SARS-CoV-2 virus, including 50% in Group I with moderate symptoms, and in Group II—most people 45% with mild symptoms. The conducted research clearly shows the impact of the COVID-19 pandemic on students. They show a number of important problems, such as reduced physical activity, as well as increased body weight and time spent in front of the monitor. They also make it clear that the health consequences of the pandemic affect both people who were infected with the SARS-CoV-2 virus and those who did not suffer from this infection.

The Impact of COVID-19 Lockdown on Patients with Lymphedema

Background: The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to management of lymphedema. The aim of this study was to assess general health conditions and evaluate the problems and concerns of lymphedema patients with regard to access to care and provision of management and control follow-ups during the lockdown period between March and June 2020. Methods: A web-based online survey, which included questions about demographic and clinical properties, compliance with restrictions and self-management, complications, needs, and difficulties in accessing health care, as well as the presence of psychological symptoms, was applied. Results: Two hundred three patients (190 female and 13 male) replied. Majority of them (73.4%) were between 30 and 60 years old and had high school/university education (67%). The duration of lymphedema was more than 3 years and sites were commonly extremities with mild to moderate intensity in 70.5% patients. Majority of them adhered to stay home warnings (88.7%). Weight gain was a common problem and self-care methods were generally skipped (81.8%). Seventeen percent of them had wounds and/or cellulitis. Forty percent of patients needed to apply to health centers to renew the pressure garment, but could not reach it. More than 70% of patients had sleep disorders and anxiety/stress. Majority of patients used television and social media to get information related to COVID-19 and the exposure time was commonly 2 to 6 hours. Conclusions: The COVID-19 lockdown had a great impact on lymphedema patients' health care not only from medical but also from psychosocial aspects. All these implications have to be identified and dealt with properly to avoid concerns and consequences of future pandemic lockdowns. Lymphedema services should be well prepared to be delivered virtually, enable effective care, and share knowledge to meet the needs of patients suffering from lymphedema.

Participation in Sports Activities before and after the Outbreak of COVID-19: Analysis of Data from the 2020 Korea National Sports Participation Survey

The present study aimed to describe the characteristics and rate of participation in sports activities, changes in sports, and the causes of these changes before and after the COVID-19 out-break in Korea using data from the 2020 Korea National Sports Participation Survey (KNSPS). Furthermore, evidence from this study could be used as basic data to maintain and promote sports activities given the current situation, in which the continued spread of infectious diseases, such as COVID-19, is likely. The KNSPS is an annual survey of subjective health and fitness, sports activities and conditions, and participation in sports activities, conducted among a sample comprising the entire Korean population. The current study analyzed data for 9000 participants, and descriptive statistical analysis was performed to calculate the frequency of each item and sample weight. The rate of regular participation in sports activities at least once a week was found to be 60.10% in 2020, representing a decrease of 6.48% from the rate observed in 2019. Among the types of sports facilities frequently used within the residential area, the most common facilities were private sports facilities (22.97%), other sports facilities (20.60%), and public sports facilities (18.97%), although the utilization rate for other sports facilities increased after the COVID-19 outbreak. After the COVID-19 outbreak, 34.12% of men and 29.72% of women responded that there had been a change in their participation in regular sports activities. Both before and after the COVID-19 outbreak, walking was the most common activity, although the participation rate increased from 29.23% in 2019 to 35.70% in 2020. The rankings and participation rates for indoor sports activities (bodybuilding, swimming, etc.) tended to decrease, while those for outdoor sports activities (climbing, cycling, etc.) tended to increase. These changes may be explained in part by the increasing concern regarding infection with increasing age, except among teenagers, and by economic factors. While participation in physical activity provides numerous health benefits, the COVID-19 pandemic has had a negative impact on regular participation in sports activities. The results of this survey suggest that government action is required to enhance participation in sports activities, even in the face of a pandemic.

Exploring Determinants of Exercise-Related Affective Valence in Regular Exercisers Between the Ages of 55 and 69 Years

This study aimed to understand determinants of recalled in-task affective valence experienced during a regularly performed aerobic bout in adult exercisers aged 55+. Qualitative data were collected (January to March, 2021, during the COVID-19 pandemic) using interviews wherein individuals (N = 16, 69% women, 61 ± 5 years) recalled deviations in affective valence in response to a regularly completed bout. Using thematic analyses, two themes emerged regarding how COVID-19 impacted regular exercise behaviors: (a) “loss” and (b) “adaptation.” Two themes encompassed the determinants of recalled in-task affective valence: (a) “person-specific conditions” and (b) “external conditions.” Finally, an increase in duration/intensity during a pleasant session was indicated by 44% of the participants, while 75% indicated a decrease in duration/intensity during an unpleasant session. The participants indicated that affective valence was determined by previously cited and novel factors that relate to exercise performed in naturalistic environments. Volitional modifications to planned exercise volume appear more responsive to feelings of displeasure.

Indonesia medical students' knowledge, attitudes, and practices toward COVID-19

Implementing health protocols and preventive measures are the only effective ways to suppress COVID-19 transmission before vaccines and antiviral drugs are developed. The implementation of health protocols and preventive measures are influenced by one's knowledge, attitudes, and practices (KAP) toward this pandemic. Medical students as candidates for healthcare workers and role models for the community should have a good KAP. This study intends 1) to explore the KAP of medical students in Indonesia toward COVID-19 and 2) to assess which demographic factors have a significant effect on their KAP scores. An online questionnaire consisting of 18 items of knowledge, six items of attitudes, and 12 items of practices were used as instruments in this study. After being distributed for two weeks in June 2020, 525 respondents whose data were worth analyzing were obtained. The respondents consisted of male and female students, from diploma to bachelor degree, and came from all four types of higher education institutions in Indonesia. The results, 48% of respondents had good knowledge, 81% had good attitudes, and 43.5% had good practices toward COVID-19. The location of students' residence has no significant effect on their KAP score. Gender has a significant effect on knowledge and practice scores. Age, institution type, and institution status have a significant effect on their three KAP domains. The KAP survey results can be used as a reflection of the importance of the curriculum that prepares medical students for the pandemic. Medical students are also expected to be able to actively participate in educating people around them on how to minimize the transmission of COVID-19 during the pandemic.

Vocal outcomes after COVID-19 infection: acoustic voice analyses, durational measurements, self-reported findings, and auditory-perceptual evaluations

PURPOSE

The ongoing literature suggests that COVID-19 may have a potential impact on voice characteristics during the infection period. In the current study, we explored how the disease deteriorates different vocal parameters in patients who recovered from COVID-19.

METHODS

A total of 80 participants, 40 patients with a prior history of COVID-19 (20 male, 20 female) with a mean age of 39.9 ± 8.8 (range, 21-53) and 40 gender and age-matched healthy individuals (mean age, 37.3 ± 8.8; range, 21-54) were included to this study. The data of acoustic voice analyses, durational measurements, patient-reported outcomes, and auditory-perceptual evaluations were compared between the study group and the control group. Correlation analyses were conducted to examine the association between the clinical characteristics of the recovering patients and measured outcomes.

RESULTS

Maximum phonation time (MPT) and the scores of both Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) questionnaires significantly differed between the groups, which was more evident in female participants. The overall severity score of dysphonia was found to be higher in the study group than the control group (p = 0.023), but gender-based comparisons reached significance only in males (p = 0.032). VHI-10 and V-RQOL revealed significant correlations with the symptom scores of the disease.

CONCLUSIONS

Patients with a prior history of COVID-19 had significantly lower MPT, increased VHI-10 scores, decreased voice-related quality of life based on the V-RQOL questionnaire, and higher overall severity scores in the auditory-perceptual evaluation. Self-reported voice complaints disclosed close relationships with the symptom scores of COVID-19 disease.

Prospective changes in physical activity, sedentary time and sleep during the COVID-19 pandemic in a US-based cohort study

OBJECTIVES

Assess differences in movement behaviours within the 24-hour cycle, including light intensity physical activity (LPA), moderate-to-vigorous physical activity (MVPA), sedentary time and sleep, before and during the COVID-19 pandemic and assess these differences stratified by several relevant factors in a subcohort of the Cancer Prevention Study-3.

DESIGN AND SETTING

US-based longitudinal cohort study (2018-August 2020).

PARTICIPANTS

N=1992 participants, of which 1304 (65.5%) are women, and 1512 (75.9%) are non-Latino white, with a mean age 57.0 (9.8) years.

MEASURES

Age, sex, race/ethnicity, education; self-reported LPA, MVPA, sedentary time and sleep duration collected before and during the pandemic; pandemic-related changes in work, childcare and living arrangement; COVID-19 health history.

RESULTS

Compared to 2018, participants spent an additional 104 min/day sedentary, 61 fewer min/day in LPA and 43 fewer min/day in MVPA during the pandemic. Time spent sleeping was similar at the two time points. Differences in movement behaviours were more pronounced among men, those with a higher level of education, and those who were more active before the pandemic.

CONCLUSIONS

From 2018 to Summer 2020, during the COVID-19 pandemic, US adults have made significant shifts in daily time spent in LPA, MVPA and sedentary. There is an urgent need to promote more physical activity and less sedentary time during this public health crisis to avoid sustaining these patterns long-term.

How do people support each other in emergencies? A qualitative exploration of altruistic and prosocial behaviours during the COVID-19 pandemic

The Ball State University Center for Peace and Conflict Studies in the United States has compiled altruistic stories from different countries such as India, Australia, the United States, and England since the onset of the COVID-19 pandemic. We examined those stories to understand (1) who receives the most support, (2) what type of support is provided, (3) who those supporters are, and (4) why people support each other during the pandemic. Conducting a qualitative content analysis of 104 altruistic stories, we first identified that (a) older individuals , (b) people with sensitive health conditions, and disabilities, (c) frontline workers, and (d) working class and marginalized communities received the primary support. Second, we identified three types of support: (a) material, (b) social/emotional, and (c) psychological. Third, we found that support was coming from (a) different organizations, (b) advantaged groups, and (c) volunteers. Last, (a) sharing a community/humanity identity, (b) allyship, and (c) showing gratitude were the reasons behind altruistic and prosocial behavior. Our findings contribute to the literature by providing some possible reasons and ways that allies have supported disadvantaged communities via sharing the available resources and how showing gratitude can be a reason for altruism and prosocial behavior in a pandemic.

Human Mobility to Parks Under the COVID-19 Pandemic and Wildfire Seasons in the Western and Central United States

In 2020, people's health suffered a great crisis under the dual effects of the COVID-19 pandemic and the extensive, severe wildfires in the western and central United States. Parks, including city, national, and cultural parks, offer a unique opportunity for people to maintain their recreation behaviors following the social distancing protocols during the pandemic. However, massive forest wildfires in western and central US, producing harmful toxic gases and smoke, pose significant threats to human health and affect their recreation behaviors and mobility to parks. In this study, we employed the geographically and temporally weighted regression (GTWR) Models to investigate how COVID-19 and wildfires jointly shaped human mobility to parks, regarding the number of visits per capita, dwell time, and travel distance to parks, during June - September 2020. We detected strong correlations between visitations and COVID-19 incidence in southern Montana, western Wyoming, Colorado, and Utah before August. However, the pattern was weakened over time, indicating the decreasing trend of the degree of concern regarding the pandemic. Moreover, more park visits and lower dwell time were found in parks further away from wildfires and less air pollution in Washington, Oregon, California, Colorado, and New Mexico, during the wildfire season, suggesting the potential avoidance of wildfires when visiting parks. This study provides important insights on people's responses in recreation and social behaviors when facing multiple severe crises that impact their health and wellbeing, which could support the preparation and mitigation of the health impacts from future pandemics and natural hazards.

Changes in Eating Habits and Lifestyles in a Peruvian Population during Social Isolation for the COVID-19 Pandemic

BACKGROUND

Peru has one of the highest infection and death rates in the world for the COVID-19 pandemic. The government implemented house confinement measures with probable consequences on lifestyle, particularly affecting eating habits, physical activity, sleep quality, and mental health.

OBJECTIVES

The aim of this study was to assess the lifestyles, physical activity, and sleep characteristics, as well as changes in eating habits in a Peruvian population during the first wave of the COVID-19 pandemic.

METHODS

A cross-sectional descriptive study was performed. We analyzed Peruvian adults based on an online self-administered questionnaire divided into sociodemographic, anthropometrics, COVID-19 diagnosis reported, lifestyle habits, and frequency of consumption of foods.

RESULTS

During confinement for COVID-19, 1176 participants were studied. Of these, most reported weight gain (1 to 3 kg) and 35.7% were overweight. The lifestyles habits showed that 54.8% reported doing physical activity and 37.2% sleep less. The Peruvian sample presented a main meal pattern of breakfast (95.7%), lunch (97.5%), and dinner (89.1%). Likewise, eating habits before and during COVID-19 pandemic showed that vegetables (OR:1.56, CI95% 1.21-200), fruit (OR: 1.42, CI95% 1.10-1.81), legumes (OR:1.67, CI95% 1.23-2.28), and eggs (OR: 2.00, CI95% 1.52-2.65) presented significant consumption increase during social isolation, while bakery products (OR: 0.74, CI95% 0.56-0.97), meat, snack, refreshment, and fast food decreased in consumption. Other foods showed no significant differences.

CONCLUSION

This study showed an important frequency of overweight and sleep changes. There was a slight increase in physical activity despite the social isolation measures and an increase in healthy eating habits; nevertheless, the majority reported gaining weight.

Impact of the COVID-19 Pandemic on Objectively Measured Physical Activity and Sedentary Behavior Among Overweight Young Adults: Yearlong Longitudinal Analysis

BACKGROUND

The COVID-19 pandemic has impacted multiple aspects of daily living, including behaviors associated with occupation, transportation, and health. It is unclear how these changes to daily living have impacted physical activity and sedentary behavior.

OBJECTIVE

In this study, we add to the growing body of research on the health impact of the COVID-19 pandemic by examining longitudinal changes in objectively measured daily physical activity and sedentary behavior among overweight or obese young adults participating in an ongoing weight loss trial in San Diego, California.

METHODS

Data were collected from 315 overweight or obese (BMI: range 25.0-39.9 kg/m²) participants aged from 18 to 35 years between November 1, 2019, and October 30, 2020, by using the Fitbit Charge 3 (Fitbit LLC). After conducting strict filtering to find valid data on consistent wear (>10 hours per day for ≥250 days), data from 97 participants were analyzed to detect multiple structural changes in time series of physical activity and sedentary behavior. An algorithm was designed to detect multiple structural changes. This allowed for the automatic identification and dating of these changes in linear regression models with CIs. The number of breakpoints in regression models was estimated by using the Bayesian information criterion and residual sum of squares; the optimal segmentation corresponded to the lowest Bayesian information criterion and residual sum of squares. To quantify the changes in each outcome during the periods identified, linear mixed effects analyses were conducted. In terms of key demographic characteristics, the 97 participants included in our analyses did not differ from the 210 participants who were excluded.

RESULTS

After the initiation of the shelter-in-place order in California on March 19, 2021, there were significant decreases in step counts (-2872 steps per day; 95% CI -2734 to -3010), light physical activity times (-41.9 minutes; 95% CI -39.5 to -44.3), and moderate-to-vigorous physical activity times (-12.2 minutes; 95% CI -10.6 to -13.8), as well as significant increases in sedentary behavior times (+52.8 minutes; 95% CI 47.0-58.5). The decreases were greater than the expected declines observed during winter holidays, and as of October 30, 2020, they have not returned to the levels observed prior to the initiation of shelter-in-place orders.

CONCLUSIONS

Among overweight or obese young adults, physical activity times decreased and sedentary behavior times increased concurrently with the implementation of COVID-19 mitigation strategies. The health conditions associated with a sedentary lifestyle may be additional, unintended results of the COVID-19 pandemic.

Evaluation of Sleep Habits, Generalized Anxiety, Perceived Stress, and Research Outputs Among Postgraduate Research Students in Hong Kong During the Coronavirus (COVID-19) Pandemic

Purpose

The current study aimed to evaluate the impact of coronavirus (COVID-19) pandemic on sleep hygiene, anxiety levels, perceived stress, and research output among postgraduate research students in Hong Kong.

Methods

An online survey was developed and distributed to Hong Kong postgraduate research students. The sleep hygiene, anxiety levels, and perceived stress during the outbreak of COVID-19 were assessed. Questions about COVID-19’s impact on research outputs were asked.

Results

A total of 108 (response rate, 72%) full-time postgraduate students (PhD, 64%; M Phil, 8%; and Masters, 28%) participated. Approximately 83% of students reported poor sleep hygiene. Similarly, nearly 76% of students reported mild to severe levels of self-perceived anxiety levels. Most of the respondents (89%) expressed a moderate level of perceived stress. Sleep hygiene scores were moderately associated with anxiety levels (r = 0.384, p < 0.01) and perceived stress scores (r = 0.423, p < 0.01). Perceived stress was strongly correlated with anxiety levels (r = 0.601, p < 0.01). A hierarchical regression analysis revealed a significant association between respondents’ ethnicity (B = −0.923, p = 0.003), past medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.112, p = 0.005), or poor sleep hygiene (B = 0.259, p = 0.000) and high levels of perceived stress. Additionally, prior medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.957, p = 0.001) and poor sleep hygiene (B = 0.312, p = 0.000) were found to be strongly related to anxiety levels among postgraduate research students.

Conclusion

This is the first study that highlights poor sleep hygiene, moderate-to-severe levels of anxiety, and perceived stress during the COVID-19 pandemic in postgraduate research students in Hong Kong. These findings will help educators to prepare strategies to alleviate the stress and psychological problems in postgraduate students.

A Qualitative Examination of COVID-19's Impacts on Physical Activity and Perceptions of Remote Delivery Interventions

Purpose

The COVID-19 pandemic is correlated with decreased physical activity (PA). Transitioning to remote work may impact people’s acceptability and preferences for remotely delivered behavioral interventions, including PA. The objective was to examine perceptions of COVID-19 impacts on PA engagement and motivation, and perspectives related to remotely delivered PA interventions.

Design

Cross-sectional small-group interview.

Setting

Harris County, Texas. Participants: Insufficiently active, overweight/obese adults (16 healthy adults [aged 25–52 years], and 7 cancer survivors [aged 50–74 years]).

Method

Group discussion was guided by semi-structured questions. Audio-transcribed data (278 pages) was analyzed using Braun and Clarke’s process centering identification, analysis, organization, description, and reports.

Results

Overall, participants expressed a decreased level of PA due to the pandemic. Difficulties (e.g., care-taking activities, working from home, and safety concerns) negatively affected motivation. Participants indicated high acceptability of remotely delivered PA interventions, with advantages of virtual technology features (e.g., did not have to maintain a gym membership) and even accountability in maintaining a PA routine (e.g., using virtual groups to engage in community support).

Conclusion

Participants described COVID-19 negatively affects access to PA opportunities yet also expressed willingness to engage in remotely delivered PA interventions instead of in-person programs because of their COVID-19 experiences. Remote interventions can greatly increase accessibility and offer opportunities to provide personalized motivation and accountability that people need to be more physically active.

Associations of obesity, physical activity level, inflammation and cardiometabolic health with COVID-19 mortality: a prospective analysis of the UK Biobank cohort

OBJECTIVES

To investigate the associations of physical activity level with COVID-19 mortality risk across body mass index (BMI) categories, and to determine whether any protective association of a higher physical activity level in individuals with obesity may be explained by favourable levels of cardiometabolic and inflammatory biomarkers.

DESIGN

Prospective cohort study (baseline data collected between 2006 and 2010). Physical activity level was assessed using the International Physical Activity Questionnaire (high: ≥3000 Metabolic Equivalent of Task (MET)-min/week, moderate: ≥600 MET-min/week, low: not meeting either criteria), and biochemical assays were conducted on blood samples to provide biomarker data.

SETTING

UK Biobank.

MAIN OUTCOME MEASURES

Logistic regressions adjusted for potential confounders were performed to determine the associations of exposure variables with COVID-19 mortality risk. Mortality from COVID-19 was ascertained by death certificates through linkage with National Health Service (NHS) Digital.

RESULTS

Within the 259 397 included participants, 397 COVID-19 deaths occurred between 16 March 2020 and 27 February 2021. Compared with highly active individuals with a normal BMI (reference group), the ORs (95% CIs) for COVID-19 mortality were 1.61 (0.98 to 2.64) for highly active individuals with obesity, 2.85 (1.78 to 4.57) for lowly active individuals with obesity and 1.94 (1.04 to 3.61) for lowly active individuals with a normal BMI. Of the included biomarkers, neutrophil count and monocyte count were significantly positively associated with COVID-19 mortality risk. In a subanalysis restricted to individuals with obesity, adjusting for these biomarkers attenuated the higher COVID-19 mortality risk in lowly versus highly active individuals with obesity by 10%.

CONCLUSIONS

This study provides novel evidence suggesting that a high physical activity level may attenuate the COVID-19 mortality risk associated with obesity. Although the protective association may be partly explained by lower neutrophil and monocyte counts, it still remains largely unexplained by the biomarkers included in this analysis.

Stay home and stay active? The impact of stay-at-home restrictions on physical activity routines in the UK during the COVID-19 pandemic

We investigated which population groups were impacted most in terms of physical activity levels during the restrictions applied during the COVID-19 pandemic. We surveyed UK residents, sampled through users of a rewards-for-exercise app (Sweatcoin; n = 749) and an online panel (Prolific; n = 907). Of the app users, n = 487 further provided daily step-count data collected by the app, prior to, and during the periods of restrictions in the UK between March-June 2020. Regression models were used to investigate factors associated with self-reported change in physical activity and change in daily step-count during the periods of restrictions. Significant factors associated with self-reported change in physical activity included rural residents (positive, b = 0.87, p < 0.001), relative to urban dwellers, people classed as obese (negative, b = -0.51, p = 0.008, relative to healthy weight) and gym users (negative, b = -1.10, p < 0.001, relative to walkers). All groups had reduced step counts during restrictions, with Black, Asian and minority ethnic groups showing greater reductions compared to White British ethnicity (negative, b = -0.18, p = 0.008). Targeted interventions are required to ensure that physical and mental health impacts of sedentary behaviour are not exacerbated over the long-term by significant reductions in physical activity identified in these groups particularly those who are also more vulnerable to COVID-19.

'Stay home when sick' advice: implications for sport and exercise

The coronavirus pandemic has given everyone in society an education on the harms of spread of respiratory illness. Young healthy athletes are far less likely to suffer severe adverse consequences of viral illnesses than the elderly and frail, but they are not completely immune. Chronic fatigue (overtraining) is an uncommon outcome and myocarditis a rare one, but they both warrant due consideration. It is, therefore, a sensible individual strategy to 'stay home when sick' if only for these risks. Traditionally though, athletes have tended to push through (train and play when ill) because of competing concerns, such as key events/matches and 'not wanting to let teammates down'. Data from both low COVID-19 and high COVID-19 countries show that the number of cardiovascular deaths in a society correlates with the number of respiratory deaths at the same time, further linking respiratory viruses to cardiovascular deaths. We are now more aware of public health obligations to prevent the spread of respiratory illnesses, in particular to protect the more vulnerable members the community. This hopefully will correspond with a change in the culture of sport to one where it is considered 'the right thing to do', to 'stay home when sick'.

Factors Associated with Reduction in Physical Activity during the COVID-19 Pandemic in São Paulo, Brazil: An Internet-Based Survey Conducted in June 2020

BACKGROUND

The COVID-19 pandemic negatively affected physical activity levels. This study investigated the factors associated with the change in physical activity level in Brazilians residing in the city of São Paulo.

METHODS

A self-administered questionnaire, addressing personal data, restriction level, education level, family income, daily working hours, and physical activity level, was answered by 2140 volunteers, of which 1179 were excluded because the answers were either incomplete or the respondents were not from São Paulo. The total number of participants selected was 961 (581 female and 380 male).

RESULTS

The physical activity level adopted prior to the pandemic period (p < 0.001) and family income (p = 0.001) correlated significantly with physical activity level reduction during the pandemic. The proportion of people who reduced their physical activity was greater among those who were very active than those who were active (adjusted prevalence ratio [aPR]: 0.65 [confidence interval (CI): 0.52-0.80]) or insufficiently active [aPR: 0.39 (0.18-0.82)]. The proportion of people who reduced their physical activity was greater among those who received a salary less than minimum wage (MW) than those who received a salary between three to six times minimum wage [(aPR: 0.50 (CI 0.35-0.70)] or more than 6 MW [(aPR: 0.56 (CI 0.40-0.79)].

CONCLUSIONS

A higher prevalence of Brazilians residing in the city of São Paulo reduced their physical activity who had a vigorous level of physical activity prior to the pandemic and who received less than a MW.

The COVID-19 pandemic affects owners walking with their dogs

The COVID-19 pandemic imposed a strict state of emergency on Belgrade residents with a curfew and restriction on movement. Therefore, the aim of this study was to determine how the measures introduced as a consequence of this disease in the capital of Serbia affected the duration of walking time of owners and their dogs. The study allowed for sociodemographics of owners, characteristics of their homes and breeds of dog. The research was conducted in the period from March 22 to April 4, 2020. In general, the COVID-19 pandemic restrictions reduced the duration of dog walks and owners' walking time. Of the 216 adult dog owners, 59% walked their dogs successfully (≥150 min/week) before the state of emergency. The number of owners who walked their dogs for ≥150 min/week decreased to only 44% (N = 96) during the state of emergency. The pandemic also decreased the number of owners who achieved total walking times of ≥150 min/week, so only 56% of them were successful in total walking time during the state of emergency (100% were successful before the pandemic, as this was one of inclusion criteria). This difference was statistically significant (P < 0.01). A Wilcoxon signed-rank test found significant differences in the total walking time before and during the state of emergency, with regard to characteristics of the owner, home and dog, with strong effect sizes for these differences (P < 0.01). McNemar's test showed that female owners, owners aged 45-64 years and owners with high income who were previously successful in walking their dogs (≥150 min/week) were more affected by the pandemic in regard to walking time with dogs (P < 0.01). Significant correlations (P < 0.01) were observed between dog breed and walking time before the state of emergency; age and walking time with the dog during the state of emergency and; age and total walking time during the state of emergency. Comparisons between different categories within the same characteristics (owner demographics, home characteristics and dog breed) by Fisher's exact test found significant differences only between younger and older dog owners in total walking time during the state of emergency (P < 0.01). Younger owners were significantly more successful in achieving ≥150 min/week total walking time than owners aged 45-64. The COVID-19 pandemic has left some owners jobless and allowed them to spend more time walking dogs. The occurrence of this disease has led to changes in the social structure of households and in the daily habits of household members. These factors have affected on the length of walking time of owners and their dogs in Belgrade.

Moderate exercise may prevent the development of severe forms of COVID-19, whereas high-intensity exercise may result in the opposite

Sedentary lifestyle increases the risk of hospitalization for COVID-19 independently of other factors. There is enough statistics to show that exercise prevents severe forms of COVID-19, but current recommendations do not set an upper limit for exercise intensity. The hypothesis presented in the paper states that intense exercise, through blood hypoxia, increases the expression of transmembrane angiotensin-converting enzyme 2 (tACE2) in the vascular endothelium, increasing the risk of developing serious forms of disease, especially in the untrained. On the other hand, moderate-intensity exercise increases the blood concentration of soluble angiotensin-converting enzyme 2 (ACE2) which has a protective role for SARS-CoV-2 infection and may prevent complications. The importance of this hypothesis consists in the revision of COVID-19 prophylaxis programs through physical exercises, with the possibility of administration of antioxidants to speed up the adaptation of vascular endothelial cells to exertion.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = −0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = −0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

It's all about control: Sense of control mediates the relationship between physical activity and mental health during the COVID-19 pandemic in Germany

COVID-19-related burden has a significant impact on mental health and has led to an increase of depression, anxiety, and stress symptoms. Physical activity has been suggested to mitigate the negative effects of the pandemic and to foster mental health. The present study aimed to investigate, whether sense of control might mediate the supposed beneficial effects of physical activity on positive (PMH) and negative mental health (NMH) in unpredictable extraordinary situations. Data were assessed in a sample of 568 students (M _age = 19.90, SD _age = 4.52) from Germany via an online survey in fall 2020. Mediation analyses revealed that sense of control mediated the relation between physical activity and PMH as well as depression, anxiety, and stress symptoms, respectively. The findings indicate that physical activity may be a promising strategy for fostering sense of control and thus mental health. Due to its practical implications and practicability, engagement in physical activity could be an effective way to reduce the NMH consequences of the current COVID-19 situation, and therefore should be addressed in actions for long-term prevention and intervention.

Changes in Alienation in Physical Education Classes, School Happiness, and Expectations of a Future Healthy Life after the COVID-19 Pandemic in Korean Adolescents

This study aims to investigate the changes in the structural relationship between alienation in physical education (PE) classes, school happiness, and future healthy life expectations in Korean adolescents after the COVID-19 pandemic. The data were collected from Korean adolescents using different scales. The collected data were analyzed using frequency analysis, reliability analysis, validity analysis, independent t test, and path analysis. The key results were: First, there were partial changes in each of the parameters since the outbreak of COVID-19. Second, before the pandemic, alienation in PE classes negatively affected school happiness, and school happiness positively affected expectations of a future healthy life; however, alienation in PE classes did not affect the expectations of a future healthy life, showing a complete mediating effect. Third, during the pandemic, alienation in PE classes negatively affected school happiness, and school happiness positively affected the expectations of a future healthy life; alienation in PE classes negatively affected the expectations of a future healthy life, showing a partial mediating effect. These findings emphasize the importance and potential of school education, especially PE, in promoting happiness and healthy lives in adolescents. We expect these findings to have practical implications for future research by presenting theoretical and empirical data.

Changes in Dietary Patterns and Clinical Health Outcomes in Different Countries during the SARS-CoV-2 Pandemic

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to an excess in community mortality across the globe. We review recent evidence on the clinical pathology of COVID-19, comorbidity factors, immune response to SARS-CoV-2 infection, and factors influencing infection outcomes. The latter specifically includes diet and lifestyle factors during pandemic restrictions. We also cover the possibility of SARS-CoV-2 transmission through food products and the food chain, as well as virus persistence on different surfaces and in different environmental conditions, which were major public concerns during the initial days of the pandemic, but have since waned in public attention. We discuss useful measures to avoid the risk of SARS-CoV-2 spread through food, and approaches that may reduce the risk of contamination with the highly contagious virus. While hygienic protocols are required in food supply sectors, cleaning, disinfection, avoidance of cross-contamination across food categories, and foodstuffs at different stages of the manufacturing process are still particularly relevant because the virus persists at length on inert materials such as food packaging. Moreover, personal hygiene (frequent washing and disinfection), wearing gloves, and proper use of masks, clothes, and footwear dedicated to maintaining hygiene, provide on-site protections for food sector employees as well as supply chain intermediates and consumers. Finally, we emphasize the importance of following a healthy diet and maintaining a lifestyle that promotes physical well-being and supports healthy immune system function, especially when government movement restrictions ("lockdowns") are implemented.

Changes in Physical Activity Are Associated with Corresponding Changes in Psychological Well-Being: A Pandemic Case Study

Societal crises and personal challenges are often followed by substantial changes in physical activity. Is there a link between such changes and psychological well-being? Seeking to answer this question, we conducted a correlational study on a representative sample in Sweden during the first year of the COVID-19 pandemic (N = 1035). About 49% of the sample had decreased their physical activity compared to their self-reported activity level prior to the pandemic, whereas 32% had increased it. The results showed a positive and robust association between changes in daily activity level and corresponding changes in psychological well-being. Specifically, individuals who had reduced their physical activity over the last year reported lower life satisfaction than before, and individuals who had increased their physical activity reported higher life satisfaction than before. The amount of complete physical inactivity (sitting) showed a similar pattern as the exercise data, meaning that individuals who reported increasing inactivity per day also reported a greater decline in life satisfaction. Additional analyses showed that the association between daily activity level and life satisfaction was somewhat stronger for men than for women, but there was no difference when comparing individual versus organized activities. The current study was based on a cross-sectional design, measuring self-reported change over time. Recent work from other research teams have used longitudinal data and experience-sampling in different settings, finding similar results. We conclude that there is good reason to recommend physical exercise as a coping strategy in difficult times.

Metaphoric Perceptions of Covid-19 Patients Related to the Disease

This study aimed to explore metaphoric perceptions of patients with COVID-19 including treatment process, family relationships, and mental health via using metaphors. Purposive sampling was used to include participants. Totally 46 patients diagnosed with COVID-19 were included in the study. The metaphor-based data collection process was carried out with three open-ended questions. The metaphors compiled according to questions and grouped by 13 themes according to analysis. Patients explained to COVID-19 process by using 91 different metaphors. Most frequently used metaphors by patients; black hole/dark for the treatment process of COVID-19, steel for family relationships, sea metaphor for mental health. This study, it was determined that individuals are afraid of death, have a serious perception of uncertainty, and their family relationships and this process negatively affected their family relationships and mental states. Nurses have important responsibilities to increase the quality of patient care.

Exploring Factors Enhancing Resilience Among Marginalized Older Adults During the COVID-19 Pandemic

Marginalized older adults are highly vulnerable to COVID-19 due to social isolation and physical and functional limitations. Despite these stressors, they appear to be resilient by leveraging individual, community, and societal resources. This study conducted in-depth interviews with marginalized older adults to understand how COVID-19 affected their mobility and daily lives. We also identified different levels of protective factors affecting their resiliency to pandemic stressors. COVID-19 influenced not only the physical health but also the mental health of older adults. However, they overcame adversity by using technology to continue daily activities, exchanging informal support with family and neighbors, relying on formal support from community organizations, and keeping themselves physically active in their neighborhoods. Our findings suggest a holistic approach to enhance the resilience of older adults during an unprecedented event.

Insufficient Physical Activity and Sedentary Behaviors among Medical Students during the COVID-19 Lockdown: Findings from a Cross-Sectional Study in Pakistan

Background: The unprecedented COVID-19 pandemic has resulted in social distancing and isolation which leads to insufficient physical activity and thereby increases sedentary behaviors. Hence, this study aimed to assess the prevalence of insufficient physical activity and sedentary behaviors among medical students during the COVID-19 lockdown in Pakistan, and to determine their associated factors. Methods: A cross-sectional online survey was carried out among 407 medical students from the Punjab and Sindh provinces between May and June 2020. To collect data, an e-questionnaire was sent to obtain informed consent along with questions concerning socio-demographics as well as an International Physical Activity Questionnaires–Short Form (IPAQ–SF). Results: As per the IPAQ, almost five in ten participants were physically inactive (48.2%), and 45.2% reported sedentary behaviors. Participants with insufficient physical activity were more likely to report sedentary behaviors than their counterparts (AOR = 2.53; 95% CI = 1.66–3.85, p < 0.001). The odds of insufficient physical activity were higher among the participants who did not strictly follow the COVID-19 preventive measures (AOR = 2.51; 95% CI = 1.35–4.69, p = 0.004); similarly, there were increased odds of sedentary behaviors observed among participants within a normal weight range compared to those who were underweight (AOR = 2.69; 95% CI = 1.76–4.11, p < 0.001). Conclusions: Insufficient physical activity and sedentary behavior are prevalent among medical students in Pakistan during the COVID-19 pandemic. These findings indicate the importance of establishing tailored policies and programs to encourage young adults to engage in physical activity.

Activities, Housing Situation and Other Factors Influencing Psychological Strain Experienced During the First COVID-19 Lockdown in Switzerland

Background: The Coronavirus disease 2019 (COVID-19) crisis and the corresponding first nationwide lockdown from mid-March to 10 May 2020 engendered considerable psychological strain among people in Switzerland. This study analyzes determinants of changes in subjective levels of psychological strain experienced during the lockdown. Methods: An online survey conducted as part of a larger mixed methods study examined the material and emotional aspects of individual reactions to the lockdown from a socio-ecological perspective. Participants (N = 5932) were asked about their personal and employment status, housing features, changes in various activities (e.g., physical activity, watching TV, social media use) and aspects of mental distress and well-being. Results: A substantial share of participants reported to feel depressed (33%) and anxious (43%) more often during the COVID-19 lockdown than before, whereas significantly (p < 0.001) less persons reported a decrease of these negative feelings (depressed 17%; anxious 14%). Women, single people, students and people who lost their jobs or were temporally unemployed due to the lockdown experienced a particularly strong increase of subjective psychological strain. Important residential factors reducing subjective psychological strain were the general comfort of the housing situation and having a private garden or multiple types of outdoor space. Considering leisure activities, the strongest positive psychological effect resulted from increased physical activities, followed by reading and cooking. However, 45% of the participants reported a decreased frequency of physical activity during the lockdown compared to before, whereas significantly less persons (26%) reported a corresponding increase (p < 0.001). Conclusion: Consistent with other studies, the results indicate a substantial reduction of subjective psychological well-being of the population during the first COVID-19 lockdown in Switzerland. The psychological burdens which the participants experienced differ depending on personal characteristics and situational factors. Negative psychological and economic consequences and gender inequalities should accordingly be carefully considered and actively prevented when designing COVID-19 measures. Supportive economic and social, cognitive and behavioral psychological interventions need to be designed and implemented to maintain the well-being of residents during lockdown.

Changes to Physical Activity, Sitting Time, Eating Behaviours and Barriers to Exercise during the First COVID-19 'Lockdown' in an English Cohort

This study aimed to determine the effect of the first English national COVID-19 lockdown on physical activity (PA), sitting time, eating behaviours and body mass in an adult cohort. This was further examined to determine whether conforming to recommended guidelines on PA and sedentary behaviour was improved. Based on an online survey (n = 818) incorporating the International Physical Activity Questionnaire Short Form (IPAQ-SF), self-reported body mass change showed that in 32.2% of participants body mass increased, with 39.1% reporting an increase in food intake. Never exercising at the gym or undertaking an exercise class (online or live), increased by 50.8% during lockdown, with 53.5% changing from exercising frequently to never exercising, suggesting a lack of engagement with online and home workouts. However, outdoor running and cycling >2 times/week increased by 38% during lockdown. Walking at least 30 min continuously on >2 occasions/week increased by 70% during lockdown with minimum 10-min walks on 7 days per week increasing by 23%. The lockdown had a negative impact on sitting time (>8 h a day), which increased by 43.6% on weekdays and 121% at weekends. Furthermore, sitting <4 h/day decreased during lockdown (46.5% and 25.6% for weekdays and weekends, respectively). Those citing tiredness or lack of time as a barrier to exercise reduced by 16% and 60%, respectively, from pre-lockdown to during lockdown. More of the sedentary group met the Public Health England PA recommendations, however most participants still did not meet the UK Government guidelines for PA. Improvements in health per additional minutes of physical activity will be proportionately greater in those previously doing <30 min/week, the area where most improvements were found although, conversely sitting time was greatly increased. This study may assist in informing whether future lifestyle changes could improve the health of the population.

Impact of COVID-19 lockdown on the epidemiology of soccer muscle injuries in Italian Serie A professional football players

OBJECTIVE

To evaluate the influence that COVID-19 lockdown had on the epidemiology of soccer musculoskeletal injuries during 2019/2020 Italian First Football League Serie A in professional football players.

METHODS

In this retrospective study we analyzed records from media-based platform (Trasfermarkt, https://www.transfermarkt.com), describing the epidemiology of muscle injuries before and after the first COVID-19 lockdown phases in Italian professional football players. We also classified the severity of the injury as the number of missing days from participation.

RESULTS

We assessed a lower prevalence of post-lockdown injuries, albeit showing a similar injury rate at 1000 game-hours (pre-lockdown: 16.9 [13.0-20.7], post-lockdown: 15.5 [9.9-21.1]; RR: 0.92 [0.46-1.8]). All risk ratios for injury rate were not significantly different (p> .05) between pre- and post-lockdown.

CONCLUSIONS

The incidence of muscle injuries has not significantly changed after the first COVID-19 lockdown in Italian professional soccer players. Recognizing injury rates might be crucial for physician to evaluate adequate preventive measures.

Safe Return to Exercise after COVID-19 Infection

COVID-19 has been posing a significant challenge to the athletic community. A wide spectrum of clinical features was reported in athletes with confirmed COVID-19 infection having mild to severe symptoms requiring hospitalisation and intensive medical care. Possibly, a lack of exercise may negatively impact the immune system, leading to an increased susceptibility to infection and comorbidities. Determining safe return to exercise after COVID-19 infection is a challenge for sports physicians. A gradual return to exercise under the guidance of a specialised medical team to achieve the pre-infection fitness level is of utmost importance. Individualised exercise programmes must be initiated at low intensity which could be gradually made more rigorous based on the pertinent metabolic equivalent. Thus, there is a clear need for clinical recommendations before athletes may return to exercise after COVID-19 infection.

The role of exercise in rehabilitation of discharged COVID-19 patients

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly caused pneumonia and pulmonary fibrosis through upper respiratory tract infection, which resulted in acute respiratory distress syndrome (ARDS) and multiorgan damage of cardiovascular, nervous, digestive, and genitourinary systems. Although the virus test turned negative after the patient recovered, the damage to multiorgan caused by SARS-CoV-2 may irreversible. Therefore, the health status of the recovered patients has gradually become the focus of people's attention. Whether coronavirus disease 2019 (COVID-19) patients can receive exercise rehabilitation training after discharge? and what's the basis? We try to analyze and answer these questions, will provide some ideas about the patients to develop a reasonable and effective exercise rehabilitation program.

Lipid profile and C-reactive protein changes to elastic-band resistance training in young healthy men

Resistance bands are a device for resistance training routine or rehabilitation program and come in various sizes, lengths, and strengths. The purpose of this study was to investigate the effect of elastic resistance training (ERT) on lipid profiles and C-reactive protein (CRP) changes in young and healthy men. Twenty untrained young and healthy men voluntarily participated in the study and were randomly assigned to the ERT (n=10) and control group (n=10). The ERT group performed three non-consecutive sessions per week for eight weeks. Blood was sampled before training and this was repeated after 72 h of the interval of the last session of ERT. The concentration of CRP and lipid profiles, including changes of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC), were measured. Also, changes in body fat percentage (BF%) were measured. It was observed that CRP was not significantly affected by ERT (P>0.05). Also, TC and TG did not change significantly due to ERT (P>0.05). However, ERT increased the HDL-C concentration (P=0.001) and significantly decreased LDL-C (P=0.033). It is concluded that although the elastic resistance training failed to improve CRP; however, with a positive impact on some of the lipid profiles and health indices, it can be a useful, simple and low-cost exercise training in health promotion.

Mass Spectrometry-based Proteomics and Glycoproteomics in COVID-19 Biomarkers Identification: A Mini-review

The first corona-pandemic, coronavirus disease 2019 (COVID-19) caused a huge health crisis and incalculable damage worldwide. Knowledge of how to cure the disease is urgently needed. Emerging immune escaping mutants of the virus suggested that it may be potentially persistent in human society as a regular health threat as the flu virus. Therefore, it is imperative to identify appropriate biomarkers to indicate pathological and physiological states, and more importantly, clinic outcomes. Proteins are the performers of life functions, and their abundance and modification status can directly reflect the immune status. Protein glycosylation serves a great impact in modulating protein function. The use of both unmodified and glycosylated proteins as biomarkers has also been proved feasible in the studies of SARS, Zika virus, influenza, etc. In recent years, mass spectrometry-based glycoproteomics, as well as proteomics approaches, advanced significantly due to the evolution of mass spectrometry. We focus on the current development of the mass spectrometry-based strategy for COVID-19 biomarkers' investigation. Potential application of glycoproteomics approaches and challenges in biomarkers identification are also discussed.

Impact of the SARS-CoV-2 Coronavirus Pandemic on Physical Activity, Mental Health and Quality of Life in Professional Athletes-A Systematic Review

Due to the rapid rate of spread of the SARS-CoV-2 coronavirus, a number of restrictions have been introduced into public spaces, including those related to the operation of sports facilities, compounding the difficulty for athletes to conduct appropriate forms of training. The aim of this study was to review current scientific reports assessing the impact of the pandemic on the physical activity, mental state, and quality of life of professional athletes. Popular scientific databases—PubMed, Scopus, and Embase—were systematically searched from the beginning of the pandemic until 12 July 2021. According to the adopted criteria, 14 articles were included in the review. Ten of the qualified studies determined the impact of the pandemic on the physical activity of athletes. The authors of 11 papers assessed the mental state and quality of life of athletes during the pandemic. The studies showed negative effects of the pandemic: a decrease in overall physical fitness and number of days and hours of training, as well as an increase in the occurrence of negative emotions (stress, fatigue, and depression) and a decrease in sleep quality. Changes in physical activity had an impact on overall well-being ratings, which depended on the sex of the subjects. Women were more likely to experience negative emotions compared to men. The mental state of the athletes affected the quality of sleep. This review summarises the negative effects of the SARS-CoV-2 coronavirus pandemic on the physical and mental health of professional athletes.

Physical activity and its relationship with COVID-19 cases and deaths: Analysis of U.S. counties

PURPOSE

The study was to examine county-level associations of physical activity with coronavirus disease 2019 (COVID-19) cases and deaths, per 100,000 county residents.

METHODS

Data were collected from publicly available data sources for 3142 counties and equivalents, including the District of Columbia. Subjective health ratings, percentage uninsured, percentage unemployed, median household income, percentage female residents, percentage White residents, percentage of residents 65 years of age or older, and rural designation served as controls.

RESULTS

The two-level random intercept regression showed that physical activity rates at the county level were statistically and negatively associated with COVID-19 cases and deaths. Additional analyses showed that physical activity rates moderated the relationship between cases and deaths, such that the relationship was strongest when physical activity rates were low.

CONCLUSION

The results presented here offer empirical evidence of the benefits of county-level physical activity during a pandemic. Implications for public health and physical activity provision are discussed.