Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

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Abstract

Background

The coronavirus disease (COVID‐19) and universal mitigation strategies have fundamentally affected peoples’ lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID‐19 pandemic.

Methods

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2–24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

Results

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher’s z = − 0.198, p < 0.001) and positive (Fisher’s z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

Conclusions

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

Supplementary Information

The online version contains supplementary material available at 10.1186/s13034-023-00629-4.

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Most cited references 146

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Julian P. T. Higgins, Simon Thompson, Jonathan Deeks … (2003)

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Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

Neeltje van Doremalen, Trenton Bushmaker, Dylan H Morris … (2021)

To the Editor: A novel human coronavirus that is now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (formerly called HCoV-19) emerged in Wuhan, China, in late 2019 and is now causing a pandemic. 1 We analyzed the aerosol and surface stability of SARS-CoV-2 and compared it with SARS-CoV-1, the most closely related human coronavirus. 2 We evaluated the stability of SARS-CoV-2 and SARS-CoV-1 in aerosols and on various surfaces and estimated their decay rates using a Bayesian regression model (see the Methods section in the Supplementary Appendix, available with the full text of this letter at NEJM.org). SARS-CoV-2 nCoV-WA1-2020 (MN985325.1) and SARS-CoV-1 Tor2 (AY274119.3) were the strains used. Aerosols (<5 μm) containing SARS-CoV-2 (105.25 50% tissue-culture infectious dose [TCID50] per milliliter) or SARS-CoV-1 (106.75-7.00 TCID50 per milliliter) were generated with the use of a three-jet Collison nebulizer and fed into a Goldberg drum to create an aerosolized environment. The inoculum resulted in cycle-threshold values between 20 and 22, similar to those observed in samples obtained from the upper and lower respiratory tract in humans. Our data consisted of 10 experimental conditions involving two viruses (SARS-CoV-2 and SARS-CoV-1) in five environmental conditions (aerosols, plastic, stainless steel, copper, and cardboard). All experimental measurements are reported as means across three replicates. SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air. This reduction was similar to that observed with SARS-CoV-1, from 104.3 to 103.5 TCID50 per milliliter (Figure 1A). SARS-CoV-2 was more stable on plastic and stainless steel than on copper and cardboard, and viable virus was detected up to 72 hours after application to these surfaces (Figure 1A), although the virus titer was greatly reduced (from 103.7 to 100.6 TCID50 per milliliter of medium after 72 hours on plastic and from 103.7 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). The stability kinetics of SARS-CoV-1 were similar (from 103.4 to 100.7 TCID50 per milliliter after 72 hours on plastic and from 103.6 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). On copper, no viable SARS-CoV-2 was measured after 4 hours and no viable SARS-CoV-1 was measured after 8 hours. On cardboard, no viable SARS-CoV-2 was measured after 24 hours and no viable SARS-CoV-1 was measured after 8 hours (Figure 1A). Both viruses had an exponential decay in virus titer across all experimental conditions, as indicated by a linear decrease in the log10TCID50 per liter of air or milliliter of medium over time (Figure 1B). The half-lives of SARS-CoV-2 and SARS-CoV-1 were similar in aerosols, with median estimates of approximately 1.1 to 1.2 hours and 95% credible intervals of 0.64 to 2.64 for SARS-CoV-2 and 0.78 to 2.43 for SARS-CoV-1 (Figure 1C, and Table S1 in the Supplementary Appendix). The half-lives of the two viruses were also similar on copper. On cardboard, the half-life of SARS-CoV-2 was longer than that of SARS-CoV-1. The longest viability of both viruses was on stainless steel and plastic; the estimated median half-life of SARS-CoV-2 was approximately 5.6 hours on stainless steel and 6.8 hours on plastic (Figure 1C). Estimated differences in the half-lives of the two viruses were small except for those on cardboard (Figure 1C). Individual replicate data were noticeably “noisier” (i.e., there was more variation in the experiment, resulting in a larger standard error) for cardboard than for other surfaces (Fig. S1 through S5), so we advise caution in interpreting this result. We found that the stability of SARS-CoV-2 was similar to that of SARS-CoV-1 under the experimental circumstances tested. This indicates that differences in the epidemiologic characteristics of these viruses probably arise from other factors, including high viral loads in the upper respiratory tract and the potential for persons infected with SARS-CoV-2 to shed and transmit the virus while asymptomatic. 3,4 Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed). These findings echo those with SARS-CoV-1, in which these forms of transmission were associated with nosocomial spread and super-spreading events, 5 and they provide information for pandemic mitigation efforts.

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Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation

L Shamseer, D Moher, Suzanne M Clarke … (2015)

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Author and article information

Contributors

Jane Jie Yu: janejy@zju.edu.cn

Journal

Journal ID (nlm-ta): Child Adolesc Psychiatry Ment Health

Journal ID (iso-abbrev): Child Adolesc Psychiatry Ment Health

Title: Child and Adolescent Psychiatry and Mental Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1753-2000

Publication date (Electronic): 19 July 2023

Publication date PMC-release: 19 July 2023

Publication date Collection: 2023

Volume: 17

Electronic Location Identifier: 92

Affiliations

[1 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, Department of Sport and Exercise Science, College of Education, , Zhejiang University, ; Hangzhou, China

[2 ]GRID grid.10049.3c, ISNI 0000 0004 1936 9692, Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, , University of Limerick, ; Limerick, Ireland

[3 ]GRID grid.1374.1, ISNI 0000 0001 2097 1371, Faculty of Education, , University of Turku, ; Rauma, Finland

[4 ]GRID grid.9668.1, ISNI 0000 0001 0726 2490, School of Educational Sciences and Psychology, , University of Eastern Finland, ; Joensuu, Finland

[5 ]GRID grid.419993.f, ISNI 0000 0004 1799 6254, Department of Psychology, , The Education University of Hong Kong, ; Hong Kong, China

[6 ]GRID grid.13402.34, ISNI 0000 0004 1759 700X, Department of Psychology and Behavioral Sciences, , Zhejiang University, ; Hangzhou, China

Article

Publisher ID: 629

DOI: 10.1186/s13034-023-00629-4

PMC ID: 10357657

PubMed ID: 37468975

SO-VID: 44835fb9-4ede-4d98-86e9-d77855ef53ca

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 April 2023

Date accepted : 12 June 2023

Funding

Funded by: The National Social Science Fund of China

Award ID: 22BTY098

Funded by: Zhejiang Provincial Philosophy and Social Science Planning Project

Award ID: 22NDJC043YB

Award Recipient : Jane Jie Yu

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: sars cov-2,depression,anxiety,stress,well-being,positive psychology

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: sars cov-2, depression, anxiety, stress, well-being, positive psychology

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

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Abstract

Background

Methods

Results

Conclusions

Supplementary Information

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 146

Measuring inconsistency in meta-analyses.

Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation

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