Implications of COVID-19-induced nationwide lockdown on children's behaviour in Punjab, India

An incidental finding during a brain plasticity study: substantial telomere length shortening after COVID-19 lockdown in the older population

The detrimental effects of lockdowns have already been proven by numerous studies, mainly using psychometric measurements. Since telomere shortening is a driver of aging and aging-associated disorders, including cognitive decline, the telomere length in the older population has been investigated in the current study. Measurements were taken over a 6-month period just before and during the 6 months that included the first lockdown. The cohort of 55 persons aged 64 to 70 years was investigated in the context of a study focusing on neuroplasticity. Participants were recruited in Germany and Switzerland and characterized by psychometric measurements concerning neurocognition and neuroplasticity. Telomere lengths were measured by real-time PCR-based LTL measurement. We found an impressive and significant decline in telomere lengths in the period that included the lockdown (2.33 (± 0.1) at T1 vs. 1.35 (± 0.1) at T2), whereas it was stable in the phase before the lockdown in the same individuals (T0 was 2.25 (± 0.1 S.E.M.) vs. T1, 2.33 (± 0.1)). Correlation of the sudden decrease revealed no linkage to health issues or general physical activity but was in trend related to a decline in the WHOQOL-BREF Social Score referring to the social interaction of the study participants. Our data support, at a biological level, the results of clinical and psychosocial studies showing the detrimental effects of lockdowns.

Inequalities in COVID-19 impact on preschool mental health in India: key moderators of adverse outcome

ABSTRACT

Introduction

Worldwide research suggests that the COVID-19 pandemic had little to no overall effect on preschool children's mental health, but that the impact is variable depending on pre-existing and COVID-19-related inequalities. Evidence from low- and middle-income country settings is sparse, yet effects may be more variable due to greater inequalities. We provide the first empirical evidence for the impact of the pandemic on emotional and behavioural problems in Indian preschool children, after accounting for normative age-related change, and test whether the impact varied depending on COVID-19-related inequalities.

Methods

Families participating in an Indian-based prospective longitudinal birth cohort (Bangalore Child Health and Development Study) provided data at age 2 years (before COVID-19) and again during COVID-19 (n=528). Mothers reported child emotional and behavioural problems and a range of COVID-19-related adverse experiences.

Results

There was a small overall pandemic effect on emotional (rate ratio (RR)=1.31, p=0.040), but not behavioural problems, after adjusting for age-related change. However, compared with the lowest risk level, emotional and behavioural problems rose higher compared with whole sample age-expected rates in families who reported the highest levels of perceived negative impact of COVID-19-related adversities (moderation p<0.001, RR=2.43 and p<0.001, RR=1.32), COVID-19 life events (p<0.001, RR=3.28, and p<0.001, RR=1.26) and time the child spent playing alone (p<0.001, RR=2.49). Emotional problems rose higher with high perceived COVID-19 maternal stress (p=0.013, RR=1.57) and with increased child mobile phone use (p<0.001, RR 1.48). Secondary analyses controlling for variation in age trends within moderator subgroups revealed these to be rarely significant. Where significant and accounted for, having more children living at home emerged as protective, whereas living below the poverty line emerged as a risk for adverse pandemic impact on child mental health.

Conclusion

A small overall increase in preschool mental health problems was evident. However, this masked substantial worsening of such problems in families with elevated COVID-19 adversities in India. These findings can inform the targeting of policy and practice initiatives to better mitigate adverse longer-term mental health outcomes arising from the pandemic response.

What do we mean when we talk about socioeconomic status? Implications for measurement, mechanisms and interventions from a critical review on adolescent mental health

Low socioeconomic status (SES) is a well-established risk factor for general and mental health problems. However, there is no widely accepted definition or operationalisation for SES, leading to varied interpretations in research. In a critical review of the child and adolescent mental health literature, we map how SES is defined and measured. We examined 334 relevant papers from 2013 to 2024 and found significant variability in the operationalisation of SES. Our analysis revealed fundamental problems such as the lack of clear definitions, insufficient detail on variables used and limited measures directly reported by adolescents. We discuss issues related to measurement techniques and their impact on reproducibility, policy development and intervention design. Based on our findings, we recommend using SES measures that directly assess the socioeconomic position of children and adolescents. Additionally, we recommend researchers improve transparency and specificity in reporting the measures used and the rationale behind their selection. The wide range of distinct measures used to represent SES, coupled with insufficient reporting, likely hampers our understanding of which underlying factors truly drive observed effects and impedes the establishment of causal relationships. This, in turn, makes the path to effective health interventions more challenging.

COVID-19 lockdown and lifestyles: A narrative review

Background

The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic had been controlling disease transmission. However, lockdown measures used to mitigate transmission affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances.

Methods

We comprehensively searched PubMed and the World Health Organization's global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed.

Results

Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes.

Conclusions

The lockdown associated with COVID-19 has largely had a negative impact on the lifestyles of individuals and communities across many countries and cultures. However, some individuals and communities also initiated positive lifestyle-related behavioral changes. If the knowledge generated by studying the impact of COVID-19-related lockdowns on the six lifestyle factors is further consolidated, it could improve chronic disease outcomes. This will help better understand lifestyle behaviors amidst crises and assist in redesigning extreme public health measures such as lockdowns.. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

Depression anxiety stress and fear of COVID-19 among adolescent students and its relationship with possible predictors

Background

During the COVID-19 pandemic prolonged lockdowns, school closures requiring online education support, and uncertainty about examinations caused stress in students.

Aim

To estimate the levels of depression, anxiety, stress, and fear of COVID-19 in adolescent students of Jamnagar and its relationship with possible predictors.

Materials and Methods

This is a cross-sectional study using a proportionate probability sampling method during the third wave of COVID-19 of 4423 adolescent students of Jamnagar, Gujarat. The Fear of COVID-19 Scale (FCV-19S) and Depression, Anxiety, and Stress Scale-21 (DASS-21) measured the main construct. T-tests for two independent samples and multiple linear regression analysis were used to assess the relationship.

Results

Among the adolescent students, 14.81% had moderate fear, while severe fear was found in 3.37%. Moderate or severe depression was observed in 1.31% and 0.16% of students, respectively; severe and extremely severe anxiety was present in 0.65% and 0.11% of students; and stress was found to be moderate in 0.23%. Depression was associated with education, anxiety with education, gender, and a history of COVID-19 in the family and stress with a history of COVID-19 infection in the family and fear of COVID-19 with gender, standard of class, geographical area, socioeconomic class, and father's education.

Conclusion

In our study, the students having a higher fear of COVID-19 were found to have higher depression, anxiety, and stress. The factors associated with a lower level of psychological impact can be used to formulate the interventions needed for the betterment of adolescent mental health.

Effects of the COVID-19 Pandemic on the Lifestyle and Mental Health of Children in the Puducherry District: A Community-Based Cross-Sectional Study

INTRODUCTION

The COVID-19 pandemic has tremendously disrupted societal behaviors and norms. People had to cope with new situations, including restrictions on free movement, home confinement, and school closures, among others. With less scope for physical classes, online classes became rampantly common during and after the pandemic. A virtual learning platform cannot replace the societal learning and preparation of children that normally occurs in school settings. The pandemic had a multifaceted impact on children, disrupting their routine work, social life, and mental health. Such uncertain circumstances are bound to interfere with their emotional well-being, with long-term consequences. It is imperative to screen for the effects of the pandemic situation among children for timely action.

METHODS

A cross-sectional survey was carried out in both rural and urban areas of Puducherry, India, between February and April 2022, toward the fag end of the pandemic. Face-to-face interviews were conducted among caregivers of 621 children aged 6-17 years. Details such as sociodemographic, personal, and behavioral aspects of the child were collected. Emotional and behavioral difficulties during the pandemic were assessed using the parent (caregiver) version of the Strengths and Difficulties Questionnaire-25 (SDQ-25). Univariate analysis was performed using the chi-square test. Four different regression models were fitted to ascertain the factors influencing the overall difficulty score as well as the SDQ subscales, namely, the internalizing, externalizing, and prosocial scores. A P value of <0.05 was considered significant.

RESULTS

Overall, 101 (16.3%) children aged 6-17 years were likely to have emotional and behavioral difficulties according to the SDQ scores. Abnormal externalizing, internalizing, and prosocial scores were documented among 160 (25.8%), 258 (41.5%), and 285 (45.9%) children, respectively. Caregivers reported disruptions in their children's academic performance (426, 68.6%), sleeping patterns (269, 43.3%), and eating habits (256, 41.2%). The use of digital devices for noneducational purposes was reported among 97 (35.9%) children. Younger caregivers (18-45 years), children who used digital devices for >2 hours per day, children who experienced any death due to COVID-19 in their family, and caregivers who perceived that the psychological changes in their children were due to the pandemic were predictors of abnormal SDQ scores. Physical activity for more than two hours per day reduced the risk of emotional and behavioral difficulties in children by 60%.

CONCLUSIONS

This research underscores the potential ramifications of the pandemic on the mental well-being and lifestyle of children. Implementing initiatives that promote positive mental health and conducting preventive screening for vulnerable populations, such as children, are considered essential, anticipating the challenges posed by such unprecedented pandemic circumstances in the future.

Intervention effects of telenursing based on M-O-A model in empty-nest older adult individuals with chronic diseases: a randomized controlled trial

Aim

This study aims to verify the effectiveness of M-O-A telenursing intervention model in improving the health status and quality of life of the empty-nest older adult individuals with chronic diseases by a randomized comparative trial.

Methods

M-O-A telenursing intervention model was constructed based on the needs of the participants. The control group (N = 39) received routine nursing, the experimental group (N = 39) received M-O-A telenursing intervention in addition to routine nursing. After 12 weeks of intervention, the intervention effects of being a participant in the two groups were evaluated. SPSS 26.0 was used for data analysis.

Results

After 12 weeks of intervention, for the experimental group, each dimension of quality of life based on EQ-5D-3L became better, especially for "pain/discomfort," "anxiety/depression," "HRQoL" and "EQ-VAS" (all p < 0.05) and each dimension of quality of life based on SF-36 became better too, especially for "GH," "BP," "RE," "MH," "VT," "SF," "PCS," "MCS," "SF-36" (all p < 0.05). In addition, there was a statistical downward trend in blood pressure, blood glucose, weight, BMI, fat rate, nap duration, number of nocturnal awakenings, light sleep rate and a statistical upward trend in water rate, basal metabolic rate, nighttime sleep duration, deep sleep rate, rapid eye movement sleep rate, especially at the end of intervention (all p < 0.05). While for the control group, there was no statistical improvement in all these aspects.

Conclusion

The M-O-A telenursing model could effectively regulate quality of life and health condition of the empty-nest older adult individuals with chronic diseases, making it worthy of further promotion and application.

The impact of the COVID-19 pandemic on children's occupations

Background

The COVID-19 pandemic changed the daily lives and limited everyday activities of children worldwide.

Objectives

To document the impact of the COVID-19 pandemic on children's occupations, the associated factors, and the impact on children's health, wellbeing, and development.

Methods

A narrative review was conducted by searching four databases (Scopus, MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews).

Results

A total of 35 articles met the inclusion criteria. Out of the 34 articles, 23 were relevant to the impact of the COVID-19 pandemic on occupations related to leisure (n = 17), productivity (n = 11), and self-care (n = 9). Ten articles highlighted specific factors that had been linked to changes in occupational engagement and child behavior. Ten articles focused on the impact of occupational disruption during COVID-19 on health, wellbeing, and general development.

Conclusion

The COVID-19 pandemic seems to have had a negative impact on children's occupations, while the restrictions were still in effect. Further research is needed to establish reliable conclusions.

Back to School after Corona Virus Disease of 2019: New Relationships, Distance Schooling, and Experienced Routine

The Corona Virus Disease of 2019 (COVID-19) pandemic has upset the students' daily routine, forcing them at first into a sudden transition to distance learning and then to a return to school modelled on the basis of infection containment measures. The present research involved 157 students from schools in central Italy with a mean age of 13.58 years old to investigate the affective impact of the pandemic on the school experience and its components (recess, oral testing, relationships with classmates, and relationship pupils-teachers). The results show that only a few have experienced school interruption in a traumatic way: they have appreciated neither distance learning, nor the return to school; for these teenagers, the school of the past has died. Other adolescents and pre-adolescents tried to replace the face-to-face mode with distance learning, maintaining certain attention to the school even during the quarantine. However, the online mode did not keep its promise. Those who have invested more in digital innovation find it difficult to return to normality today. For all of them, socialization mediated by school experience is decisive in supporting the return to ordinary life after the pandemic.

The impact of COVID-19 lockdown on child and adolescent mental health: systematic review

COVID-19 was declared a pandemic in March 2020, resulting in many countries worldwide calling for lockdowns. This study aimed to review the existing literature on the effects of the lockdown measures established as a response to the COVID-19 pandemic on the mental health of children and adolescents. Embase, Ovid, Global Health, PsycINFO, Web of Science, and pre-print databases were searched in this PRISMA-compliant systematic review (PROSPERO: CRD42021225604). We included individual studies reporting on a wide range of mental health outcomes, including risk and protective factors, conducted in children and adolescents (aged ≤ 19 years), exposed to COVID-19 lockdown. Data extraction and quality appraisal were conducted by independent researchers, and results were synthesised by core themes. 61 articles with 54,999 children and adolescents were included (mean age = 11.3 years, 49.7% female). Anxiety symptoms and depression symptoms were common in the included studies and ranged 1.8-49.5% and 2.2-63.8%, respectively. Irritability (range = 16.7-73.2%) and anger (range = 30.0-51.3%), were also frequently reported by children and adolescents. Special needs and the presence of mental disorders before the lockdown, alongside excessive media exposure, were significant risk factors for anxiety. Parent-child communication was protective for anxiety and depression. The COVID-19 lockdown has resulted in psychological distress and highlighted vulnerable groups such as those with previous or current mental health difficulties. Supporting the mental health needs of children and adolescents at risk is key. Clinical guidelines to alleviate the negative effects of COVID-19 lockdown and public health strategies to support this population need to be developed.

High-risk children and social isolation: the importance of family functioning

High-risk newborns are exposed to neonatal conditions such as prematurity, very low birth weight, and congenital malformations that can affect development and behavior. Coronavirus disease 2019 (COVID-19) restraint and control measures have been identified as important stressor events and cumulative risk factors for behavioral changes in these children. This study examined social isolation-related factors that contribute to internalizing and externalizing behavior problems in children already at risk for neurodevelopmental disorders. This cross-sectional, multicenter study included 113 children (18 months to 9 years) who were followed in reference services for neonatal follow-up in tertiary units of the public health system in the city of Rio de Janeiro, Brazil. Behavior was assessed using the child behavior checklist, and a structured questionnaire was used to assess sociodemographic aspects. In the bivariate analysis, prematurity was associated with externalizing problems and change in eating habits with internalizing problems. The logistic model indicated that both parents having completed high school and both sharing care of the child were protective factors for behavioral problems; however, reports of sleep problems and living with another child were risk factors. In conclusion, the study identified internalizing and externalizing behavior problems related to prematurity and aspects of family structure and routine in children at risk. The findings confirm the importance of family functioning for child health and family-centered interventions.

Correlation between screen time and psychosomatic symptoms in children during COVID-19 pandemic-related lockdown

BACKGROUND

This study was planned to estimate the effect of lockdown on psychosomatic problems and sleep of children and their association with screen the time during the lockdown.

METHODS

A cross-sectional study was conducted among 1-12-year-old children at a tertiary care hospital in South India. A pre-validated questionnaire with 20 related questions was disseminated through pediatric OPD, telemedicine service, and social media to eligible parents.

RESULTS

A total of 278 children aged 1-12 years with a mean (SD) age of 6.92 (3.01) years were studied. Most under 5-year-oldchildren had screen time of ≤2 hours/day, whereas 58.16% of children between 5 and 12 years spent >4 hours/day (P < 0.000). A significant proportion of participants aged 5-12 years had vision problems (P = 0.019), whereas under 5-year-old children had significant associated behavioral changes (P = 0.016) and sleep problems (P = 0.043).

CONCLUSION

Behavioral and sleep problems were significantly high and correlated with an increase in screen time among under 5-year-old children. Vision problems were more in 5-12-year-old children.

Epidemic of Depression and Anxiety in child and adolescent population during COVID-19 pandemic: A systematic review and meta analysis of the prevalence of depression and anxiety

COVID-19 has caused mayhem in the life of people. It has disrupted the social fabric of life. The children and adolescent population has been particularly affected by its direct and indirect effects. This systematic review aims to find the prevalence of depression and anxiety in children and adolescent age groups. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for finding the prevalence of depression and anxiety. We found the total number of participants to be 71,016. A random effect model was used for conducting meta-analysis. The prevalence of depression was mentioned in 17 studies of 23 and the pooled prevalence was 27% [95% confidence interval: 21%-36%] and heterogeneity (I2 statistics; P <.00001) was 100%. The prevalence of anxiety was found in 20 studies of 23 and the pooled anxiety prevalence was 25% (95% confidence interval: 16%-41%) and heterogeneity (I2 statistics; P < .00001) was found to be 100%. The summary of the findings has been provided. Due to high heterogeneity, moderator analysis was performed separately for depression and anxiety subgroups. The study design consisted of cross-sectional studies and some studies conducted through online surveys. The age range varied considerably from 1 year to 19 years; 5 studies had participants aged more than 19 years, but the mean age of the total sample was less than 18 years. We conclude that indeed there is a mental health epidemic among the child and adolescent population. We recommend early intervention and tailored made strategies should for management. As the pandemic is enduring, rigorous monitoring should be done. This age group is under extra pressure owing to a large uncertainty about their studies as well their future.

Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review

BACKGROUND

In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status.

AIMS

This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures.

METHODS

Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains.

RESULTS

The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices.

CONCLUSIONS

Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.

Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.

Pediatric emergency care admissions for somatic symptom disorders during the COVID-19 pandemic

During the COVID-19 pandemic, children and adolescents with psychiatric disorders experienced an exacerbation of their symptoms with more access to the emergency department (ED). However, little is known about the experience of somatic symptom disorders (SSDs) during the COVID-19 pandemic in children. Therefore, we aimed to compare the rates of pediatric ED admissions for SSDs before and during the COVID-19 pandemic and to understand whether the relative risk of ED admissions for SSDs changed between the two periods. We retrospectively enrolled all children between 4 and 14 years admitted for SSDs in the pediatric ED of Santobono-Pausilipon Hospital, Naples, Italy, from March 11th, 2020, to March 11th, 2021 (pandemic period), and in the same time period of the previous year (pre-pandemic period). We identified 205/95,743 (0,21%) children with SSDs presenting in ED in the pre-pandemic year and 160/40,165 (0,39%) in the pandemic year (p < 0.05). Considering the accesses for age, we observed a relative decrease of the accesses for SSDs over 12 years old (IRR 0,59; CI 0,39-0,88), while we found no differences under 12 years old (IRR 0,87; CI 0,68-1,10).   Conclusion: In this study, we found that despite the massive decrease in pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders' admissions to the pediatric ED increased, suggesting an impact of the pandemic also on pediatric psychiatric disorders. What is Known: • During the COVID -19 pandemic, children and adolescents with a psychiatric disorder experienced exacerbation of their symptoms with more accesses in Emergency Department. What is New: • We found that despite the massive decrease of the pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders admissions in healthy children to the pediatric Emergency Department increased ,suggesting an impact of the pandemic also on the pediatric psychiatric disorders.

Physical Activity and Screen Viewing Behaviors Among Children Aged 6-9 Years During the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic resulted in many restrictions worldwide, including lockdowns and school closures. This may have prevented children from meeting the recommended physical activity (PA) levels and screen time. The aim of this study was to examine the impact of the pandemic on school-age children's PA and screen time in Saudi Arabia.

METHODS

A cross-sectional study where caregivers of children aged 6-9 years living in Saudi Arabia were recruited through convenience sampling to fill out an online survey between July and August 2020. The survey covered demographic information, PAs, and screen time across 3 periods: pre-COVID-19 pandemic, during the COVID-19 lockdown, and the last 7 days preceding the survey during the pandemic where social distancing applied, but no lockdown.

RESULTS

A total of 339 caregivers completed the online survey about their children. The number of active children slightly increased during the lockdown (9.7%) than before COVID-19 and the last days (5.8%); however, the average reported days of PA during the pandemic were fewer than before. The findings indicated that all 3 types of screen time (watch time, screenplay, and device time) were longer during the pandemic (mean [SD]: 9.5 [5.5]) than before the COVID-19 (mean [SD]: 5.8 [5.1]).

CONCLUSION

While the proportion of active children had increased during the lockdown, the COVID-19 pandemic, the COVID-19 pandemic negatively impacted PA days and screen time in school-age children. School-age children in Saudi Arabia were already far from meeting global guidelines even before the pandemic, highlighting this population's need for healthy lifestyle promotion.

The impact of the COVID-19 pandemic on young children and their caregivers

BACKGROUND

The COVID-19 pandemic has adversely impacted child development and the well-being of caregivers, and such evidence ought to be used to inform public policy decisions. This study investigated the impact of COVID-19 on children's behaviours and their caregivers' needs.

METHODS

A cross-sectional study was conducted with 153 caregivers of children (from 0 to 5 years old) from three public daycare centres in Brazil. The Nurturing Care Framework of the World Health Organization was used to guide the assessment of caregivers' needs. Online data collection using a questionnaire was conducted from June to July 2020.

RESULTS

The COVID-19 pandemic increased stressors such as low family income, unemployment, sadness, depression and anxiety of caregivers. Their most commonly reported needs were related to offering age-appropriate playful activities (49.7%), organizing the care routine of children at home (41.8%) and educating children when they do something wrong (39.9%). Additionally, the results showed that misbehaviour, aggressiveness and agitation occurred more frequently among preschoolers than infants or toddlers (p ≤ 0.05).

CONCLUSION

During the COVID-19 pandemic, public policies should provide mental health support to caregivers, as well as information about security, safety and early learning opportunities for childcare at home.

Epidemics, Lockdown Measures and Vulnerable Populations: A Mixed-Methods Systematic Review of the Evidence of Impacts on Mother and Child Health in Low-and Lower-Middle-Income Countries

BACKGROUND

The aim of this research was to synthetise the existing evidence on the impact of epidemic-related lockdown measures on women and children's health in low- and lower-middle-income countries (LLMICs).

METHODS

A mixed-methods systematic review was conducted of qualitative, quantitative and mixed-methods evidence. Between 1st and 10th of November 2021, seven scientific databases were searched. The inclusion criteria were that the paper provided evidence on the impact of lockdown and related measures, focused on LLMICs, addressed impacts on women and child's health, addressed epidemics from 2000-2020, was peer-reviewed, provided original evidence, and was published in English. The Joanne Briggs Institute's critical appraisal tools were used to assess the quality of the studies, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. The evidence from the papers was grouped by type of lockdown measure and categories of impact, using a narrative data-based convergent synthesis design.

RESULTS

The review process identified 46 papers meeting the inclusion criteria from 17 countries that focussed on the coronavirus disease 2019 (COVID-19) and Ebola epidemics. The evidence on the decrease of utilisation of health services showed plummeting immunisation rates and faltering use of maternal and perinatal services, which was linked to a growth of premature deaths. Impacts on the mental health of children and women were convincingly established, with lockdowns associated with surges in depression, anxiety and low life satisfaction. Vulnerability may be compounded by lockdowns, as livelihoods were disrupted, and poverty levels increased.

CONCLUSION

Limitations included that searches were conducted in late-2020 as new research was being published, and that some evidence not published in English may have been excluded. Epidemic-related lockdown measures carry consequences for the health of women and children in lower-income settings. Governments will need to weigh the trade-offs of introducing such measures and consider policies to mitigate their impacts on the most vulnerable.

Emotional impact on children during home confinement in Spain

Introduction

The COVID-19 pandemic has brought about important changes. On March 14, 2020, a strict home confinement was decreed in Spain. Children did not attend school and were not allowed to leave their homes. The aim of this study was to determine the emotional state of these children, as well as associated factors.

Material and methods

A cross-sectional descriptive study was conducted using an online questionnaire sent by cell phone. This survey includes sociodemographic items and questions concerning the emotional impact of the lockdown. With the questions on emotions, two categories of emotional state were established with the variables fear, irritability, sadness and somatization: those who were less or more emotionally affected. A multivariate logistic model was used to estimate the associations between the variables.

Results

A total of 3,890 responses were obtained. The mean age of the children was 6.78 years (range 0 to 16). A score indicating poor emotional state was reported by 40.12%. The multivariate logistic model for poor emotional state was directly associated with having less appetite, sleep disturbances, and with parents' beliefs that their child will have difficulties returning to normal life after lockdown. A better emotional state was associated with being an only child, access to outdoor spaces at home, having pets, and parents informing their children about the pandemic using creative explanations.

Conclusions

During strict home confinement, a considerable emotional impact was observed in children as described by their parents. Specific elements were associated with a better or poorer emotional state.

Have the COVID-19 pandemic and lockdown affected children's mental health in the long term? A repeated cross-sectional study

OBJECTIVE

The study aimed to evaluate the impact of the COVID-19 pandemic on levels of anxiety and depressive symptoms in children and adolescents.

DESIGN

Cross-sectional surveys were carried out on the mental health of children; one survey was conducted before the COVID-19 pandemic and one into the pandemic, 15 months after the school closures and implementation of lockdown and social distancing. Demographic data and COVID-19 pandemic-related data were collected from specific parent-report and self-report questionnaires.

PARTICIPANTS

Participants included children and adolescents between ages 6 and 16 years, attending a tertiary care hospital without any diagnosed major psychiatric or chronic disorder.

ANALYSIS

Data were collected at two points (before the COVID-19 pandemic and during it) and compared. Levels of anxiety and depressive symptoms were compared and tested for statistically significant differences between these two points using appropriate statistical tests. Regression models were constructed to predict the factors affecting increased anxiety levels and depressive symptoms in the COVID-19 period.

RESULTS

832 and 1255 children/adolescents were included in the study during the pre-COVID-19 and COVID-19 times, respectively. The median age of the participants was 10 years (IQR=4 years). The median (IQR) Spence Children's Anxiety Scale score was 24 (12) at the pre-COVID-19 point and 31 (13) during the COVID-19 pandemic (p<0.001, r=-0.27). 11% and 16% of children reported being depressed at these two-time points, respectively (p=0.004, φ_c=-0.063). Regression analysis showed that many factors, including the duration of smartphone use, female gender and only child status, were associated with increased anxiety or depression levels.

CONCLUSION

A large proportion of children had elevated anxiety and depressive symptoms during the pandemic relative to before the pandemic, suggesting a need for measures to engage children in healthy habits to protect children's mental health and continuous monitoring of children during such scenarios.

Parental mental health and child anxiety during the COVID-19 pandemic in Latin America

This study examined parents' (N = 10,141, 64% women) reports of their and their childrens' depression, anxiety, and stress in Brazil, Mexico, Colombia and Argentina. The data come from the COVID-19 Family Life Study (Ben Brik, 2020) and cohort recruited between April and December 2020. Participants completed online surveys that included the DASS-21 and the Revised Children's Manifest Anxiety Scale. Our findings indicate that socio-economically disadvantaged families fared worse in mental health during the early phases of the COVID-19 pandemic compared with families with more social and economic resources. Mothers reported higher anxiety, depression, and stress compared with fathers. Parents of adolescents and adolescents fared worse than did families with younger children. Parental physical activity was associated with better parent and child mental health of anxiety symptoms. We discuss the need to address the adverse impacts of the COVID-19 pandemic on mental health in families in Latin America via coordinated mental health and psychosocial support services that are integrated into the pandemic response currently and after the pandemic subsides.

Mental Health during COVID-19 Pandemic: Qualitative Perceptions among Lithuanian Adolescents

BACKGROUND

Since the COVID-19 pandemic emerged, humanity has had to face unprecedented change in daily routines. Therefore, the pandemic has also had an impact on mental health. Most of the literature analyzes adult experiences during the COVID-19 pandemic, while the youth is less investigated. The purpose of this study was to reveal adolescent experiences during COVID-19.

METHODS

This qualitative study consisted of 19 adolescents from 11-17 years old. Semi-structured in-depth interviews were conducted, and thematic analysis was applied.

RESULTS

Five themes were identified: ambivalent feelings; daily routine changes; disappointment with distance education; coping strategies; and discoveries.

CONCLUSION

The study revealed adolescents' mostly negative feelings such as sadness, anger, loneliness, or boredom. They shared about frustrating daily routine changes and shifting to a distance education mode that was quite limited in effectiveness and convenience. Nonetheless, communication with family, peers, pets, active leisure, and favorite activities helped them to cope with the difficulties during COVID-19. During this period, adolescents had more free time for themselves and personal growth, found new activities, or improved some relationships. Overall, the COVID-19 pandemic had mostly negative side effects, and regardless of positive experiences, it was mainly considered by adolescents as an adversity for their mental health.

Possible Relationship Between the Oral and Gut Microbiome, Caries Development, and Obesity in Children During the COVID-19 Pandemic

The COVID-19 pandemic has brought health damage and socioeconomic disruptions, together with lifestyle disorders around the world. Children are one of the most commonly affected, mainly due to social isolation and changes in eating habits and physical activities. This way, the risk of weight gain and obesity is possibly enhanced, as well as poor oral hygiene conditions and early childhood caries (ECC) development during the lockdown. In children under 6 years of age, ECC is defined as carious lesions in one or more primary teeth, with or without cavitation. Importantly, alterations in the oral microbiome caused by changes in children lifestyles have much more than a local impact on oral tissues, interplaying with the gut microbiome and influencing systemic environments. Recent studies have been exploring the oral health conditions, eating habits, and weight gain in the childhood population during the COVID-19 pandemic; however, there is a lack of information concerning the association among oral and gut microbiome, dental caries, and obesity in the COVID-19 era. In this context, this review aimed at analyzing a possible relationship between the oral and gut microbiome, caries, and obesity in children during the COVID-19 pandemic.

Re-imaging everyday routines and educational aspirations under COVID-19 lockdown: Narratives of urban middle-class children in Punjab, India

Based on in-depth interviews with 24 middle-class Indian child participants, this is the first exploratory qualitative study, in India, to demonstrate the ways in which children as reflexive social actors re-negotiated everyday schedules, drew on classed resources at their disposal and made sense of the impact of the pandemic on their educational pathways and future aspirations. These narratives offer a unique lens on the politics of middle-classness and its constitutive relation to constructions of normative childhoods in contemporary India. Study findings contribute to the sociology of Indian childhood and more generally help enrich our understanding of southern childhoods and the reproduction of inequalities in contemporary India.

Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review

BACKGROUND

The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic's global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes.

METHODS

We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme.

RESULTS

Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes.

CONCLUSIONS

This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.

Psychosocial Effects of COVID-19 in the Ecuadorian and Spanish Populations: A Cross-Cultural Study

The world's population is currently overcoming one of the worst pandemics, and the psychological and social effects of this are becoming more apparent. We will present an analysis of the psychosocial effects of COVID-19: first, a cross-sectional study in an Ecuadorian sample (n = 301) and second, a comparative study between two samples from the Ecuadorian and Spanish populations (n = 83 each one). Participants completed an online survey to (1) describe how they felt (depression, anxiety, and stress) before and after confinement; (2) analyze which emotional and behavioral variables predict depressive symptoms, anxiety, and stress perceived after the confinement; (3) carry out a comparative study in a sample of Ecuadorian and Spanish surveys. Results indicate, first, that Ecuadorians experience significantly more depressive symptoms, anxiety, and stress after confinement. Second, variables which predict depressive symptoms and anxiety are greater public prosocial tendency, less stress as a challenge, and greater stress as a threat, as well as an empathetic tendency that implies greater emotional regulation. Experienced stress after confinement was predicted by a greater public prosocial tendency, as well as an empathetic tendency. Finally, scores for depression, anxiety, and stress are higher after confinement in both countries. However, results reveal the similarity of the psychosocial effects that are being experienced, regardless of the country, and the differences in the variables that can help explain these effects. This can contribute to the constitution of intervention plans which aim to soften and alleviate the effects produced by a situation such as that experienced with COVID-19.

Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey

Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey. Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children. Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups. In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar. Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.

Effects of COVID-19 home confinement on sleep in children: A systematic review

Our main aim was to examine the evidence of the effects of coronavirus disease confinement on the sleep of children aged 12 years and younger. A systematic review was conducted following the recommendations for Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, Cumulative Index for Nursing and Allied Health Literature, Excerpta Medica Database, Psychological Information Database, and Web Of Science were systematically searched between the period of January 2020 and March 2021. The quality assessment was analysed with the Newcastle–Ottawa quality assessment scale and the National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. The appraisal tool for cross-sectional studies was applied to cross-sectional studies and each longitudinal study was assessed with the critical appraisal skills programme. Data analysis was carried out through a narrative review. Eight studies were included in the review. Seven studies reported changes in sleep routines and five studies focused on sleep disturbances during confinement. The most important findings were a longer duration of sleep time, an increase in sleep latency, and daytime sleepiness. Whether or not the adverse changes to sleep patterns and bedtime routines seen during the home confinement period have any long-term consequences for children's sleep and daytime functioning remains unknown.

COVID-19 school and kindergarten closure relates to children's social relationships: a longitudinal study in Japan

The COVID-19 pandemic has led children to experience school closures. Although increasing evidence suggests that such intense social quarantine influences children’s social relationships with others, longitudinal studies are limited. Using longitudinal data collected during (T1) and after (T2) intensive school closure and home confinement, this study investigated the impacts of social quarantine on children’s social relationships. Japanese parents of children aged 0–9 years (n = 425) completed an online questionnaire that examined children’s socio-emotional behavior and perceived proximity to parents or others. The results demonstrated that social quarantine was not significantly related to children’s socio-emotional behavior across all age groups. However, changes in children’s perceived proximity varied depending on certain age-related factors: elementary schoolers’ perceived closeness to parents significantly decreased after the reopening of schools, whereas that to others, such as peers, increased. Such effects were not observed in infants and preschoolers. The follow-up survey 9-month after the reopening of schools (T3; n = 130) did not detect significant differences in both children’s socio-emotional behavior and perceived proximity from that after the intense quarantine. These findings suggest that school closure and home confinement may have influenced children’s social development differently across their age, and its effects were larger in perceived closeness rather than social behavior.

Management of Children Admitted to Hospitals across Bangladesh with Suspected or Confirmed COVID-19 and the Implications for the Future: A Nationwide Cross-Sectional Study

There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO ‘Watch’ list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.

Impact of the COVID-19 pandemic on children's mental health: A systematic review

BACKGROUND

The outbreak of COVID-19 in December 2019 has caused unprecedented disruption to the structure of children's daily lives due to school closures, online learning, strict social distancing measures, limited access to outdoor activities and many other restrictions. Since children are more susceptible to stress than adults and there is a growing concern about the potential debilitating consequences of COVID-19 for children's mental health, the present review aims to provide empirical evidence on the groups who are most at risk of mental health problems and uncover the risk and protective factors of children's mental health.

METHODS

A systematic search was performed, in accordance with PRISMA guidelines, in the electronic databases Web of Science (including SSCI and A&HI) and EBSCOhost (including ERIC, MEDLINE and APA PsycArticles and APA PsycINFO), for any empirical studies published between January 2020 and February 2022 that focused on children ≤ 12 years old.

RESULTS

An initial search identified 2,133 studies. A total of 30 studies fulfilled the inclusion criteria and were analyzed. The evidence showed that many children were affected by the COVID-19 pandemic and experienced internalizing and externalizing behaviors. Worsened child mental health outcomes reflected socioeconomic inequalities as most at-risk children had parents with low educational attainment, were from families of low socioeconomic status and lived in small homes. Key risk factors were identified, including unhealthy lifestyle behaviors (extended screen time, sleep disturbances and less physical activity), increased pandemic-related stressors among parents and deteriorated mental health of parents, which were directly or indirectly associated with the pandemic safety measures, such as home confinement or social distancing. Protective factors including parents' resilience, positive parent-child relationship and school connectedness in relation to children's mental health were reported.

CONCLUSION

The overall results highlight the urgent need for the implementation of tailor-made interventions for children with signs of internalizing and externalizing behaviors. Health promotion and prevention strategies by the government to maintain the mental health of children, particularly those from lower SES families who are at higher risk of worsened mental health are essential for post-pandemic policies.

Exploring the impact of COVID-19 on the movement behaviors of children and youth: A scoping review of evidence after the first year

PURPOSE

The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019 (COVID-19) pandemic and movement behaviors (physical activity, sedentary behavior, and sleep) of school-aged children (aged 5-11 years) and youth (aged 12-17 years) in the first year of the COVID-19 outbreak.

METHODS

Searches for published literature were conducted across 6 databases on 2 separate search dates (November 25, 2020, and January 27, 2021). Results were screened and extracted by 2 reviewers (DCP and KR) independently, using Covidence. Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.

RESULTS

A total of 1486 records were extracted from database searches; of those, 150 met inclusion criteria and were included for analysis. Of 150 articles, 110 were empirical studies examining physical activity (n = 77), sedentary behavior/screen time (n = 58), and sleep (n = 55). Results consistently reported declines in physical-activity time, increases in screen time and total sedentary behavior, shifts to later bed and wake times, and increases in sleep duration. The reported impacts on movement behaviors were greater for youth than for children.

CONCLUSION

The COVID-19 pandemic is related to changes in the quantity and nature of physical activity, sedentary behavior, and sleep among children and youth. There is an urgent need for policy makers, practitioners, and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.

Narrative review: COVID-19 and pediatric anxiety

The coronavirus (COVID-19) pandemic has brought focus to the effects of anxiety on children. This study aimed to review the existing literature regarding the impact of the pandemic on pediatric anxiety. This review analyzed the existing literature between the open-sourced collection on PubMed inputting "anxiety disorder in children during pandemic" and "pediatric anxiety OR child anxiety AND COVID" and that of the Journal of the American Academy of Child & Adolescent Psychiatry using the keywords "social anxiety AND COVID." This yielded 149 + 312 (461) entries and 68 articles were selected. Anxiety was found to have a prevalence of 18.9-23.87% in children during the COVID-19 pandemic whereas adolescent populations demonstrated a prevalence of 15.4-39.9%. Female gender was the most studied risk factor and physical activity was the most documented preventative factor. This review supported the notion that the COVID-19 pandemic is a major contributor to anxiety in the pediatric population.

COVID-19 within families amplifies the prosociality gap between adolescents of high and low socioeconomic status

COVID-19 has had worse health, education, and labor market effects on groups with low socioeconomic status (SES) than on those with high SES. Little is known, however, about whether COVID-19 has also had differential effects on noncognitive skills that are important for life outcomes. Using panel data from before and during the pandemic, we show that COVID-19 affects one key noncognitive skill, that is, prosociality. While prosociality is already lower for low-SES students prior to the pandemic, we show that COVID-19 infections within families amplify the prosociality gap between French high school students of high and low SES by almost tripling its size in comparison to pre-COVID-19 levels.

The lockdown effects on a pediatric obese population in the COVID-19 era

Background

The social consequences of COVID-19 pandemic are universally known. In particular, the pediatric population is dealing with a radical lifestyle change. For some risk categories, such as overweight or obese children, the impact of home confinement has been greater than for others. The increased sedentary life, the wrong diet and social distancing have stopped the chance of losing weight.

The aims of this study were to analyse the impact of COVID-19 lockdown on the behavior changes in a obese pediatric population and to explore the correlation between the new lifestyle and the level of parental instruction.

Methods

Data show features of 40 obese and overweight pediatric patients of our Clinic in Messina (Italy). We evaluated weight, height, BMI and other biochemical parameters: total cholesterol, HDL, LDL, triglyceride, transaminases, glycemia and insulinemia. After the lockdown, we contacted all patients in order to get some information about diet, physical activity and sedentary lifestyle changes in correlation to the level of their parents’ instruction. Additionally, we also evaluated 20 children twice from a clinical and laboratory perspective.

Results

The study showed an increase of daily meals during COVID-19 lockdown (3.2 ± 0.4 vs 5 ± 1, P < 0.001). In particular, children whose parents have primary school diploma ate a greater significant number of meals during the lockdown, compared to those who have parents with secondary school diploma (P = 0.0019). In addition, the 95% of patients did low physical activity during the lockdown and the 97.5% spent more time in sedentary activity. Even if BMI’s values don’t show significant differences, they have increased after the lockdown. We didn’t find any correlation between biochemical parameters before and after the lockdown.

Conclusion

The lockdown has had bad consequences on good style of life’s maintenance in overweight and obese children. The absence of a significant correlation between the worsening of biochemical parameters and the lockdown doesn’t allow to exclude any long-term consequences. It’s safe to assume that, if the hours spent in sedentary activity and the number of meals don’t diminish, there will probably repercussion on the biochemical parameters.

COVID-19 lockdown and lifestyles: A narrative review

Background: The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic has been controlling disease transmission. However, lockdown measures used to mitigate transmission have affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature has emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances. Methods: We comprehensively searched PubMed and the World Health Organization’s global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed. Results: Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes. Conclusions: The COVID-19 pandemic provides an opportunity to better understand the negative impact of strict lockdown measures on lifestyles. At the same time, it helps us identify and initiate positive behavioral changes, which, if consolidated, could improve chronic disease outcomes. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

Implications of COVID-19-induced nationwide lockdown on children's behaviour in Punjab, India

BACKGROUND

Lockdown is one of the prevalent tools that are used to control the spread of COVID-19 virus in India. Under the circumstances created during lockdown period, children are deprived from the social interaction and companionship; because of which, they are susceptible to psychiatric disorders. Therefore, in this study, efforts were to understand the impacts of lockdown on the mental status of the children of India and their specific causes.

STUDY DESIGN

It is a questionnaire-based study.

METHODS

A web-based questionnaire was prepared, and 400 parents from four districts of Punjab, India, namely, Ludhiana, Sahibzada Ajit Singh (SAS) Nagar, Sangrur and Ferozepur, were telephonically interviewed. Further, the information collected from the interviews was statistically analysed using Statistical Package for the Social Sciences (SPSS) software.

RESULTS

Findings from this study revealed that 73.15% and 51.25% of the children were having signs of increased irritation and anger, respectively; 18.7% and 17.6% of the parents also mentioned the symptoms of depression and anxiety, respectively, among their children, which were also augmented by the changes in their diet, sleep, weight and more usage of the electronic equipment. Children (~76.3%) persistently urge to go outdoors and play with their friends; therefore, they could lag in social development. Further, observations from Pearson's correlation revealed that during lockdown, children's mental health is significantly related to the area of their house, number of children in the family, qualification of their mother and socio-economic status of their family.

CONCLUSIONS

This study made it evident that the mental health of the children residing in Punjab, India, was compromised during the lockdown period induced by the COVID-19 pandemic. Findings of this study may also trigger the international authorities to frame the guidelines of lockdown in the interest of mental health of their native children.