Impact of COVID-19 lockdowns on mental health and exercise routines of Portuguese physically active subjects

Background. Lockdown is recognized as an effective measure in limiting the spread of coronavirus (COVID-19) throughout the world. However, recurrent COVID-19 infection and the extension of lockdown have threatened the livelihoods of people, mainly socioeconomic and mental health dimensions. Objective. The present study is aimed at identifying the impact of COVID-19 lockdown on the daily life and mental health of the general population of Nepal. Furthermore, the study identified the predictors of the mental health status of the people during COVID-19 lockdown. Methods. The study was conducted among 354 Nepalese people specifically the breadwinner of the family. Respondents completed the questionnaires related to the sociodemographic characteristics, COVID-19, and its impact on various aspects of life, including mental health via Depression, Anxiety, and Stress Scale-21 items (DASS-21). Data was collected through the web-based method, Google Forms questionnaire. Respondents were contacted through email and social networks (Facebook, Messenger, WhatsApp, and Viber) following a snowball approach. Data was analyzed using descriptive and inferential statistics. Logistic regression analysis was done to identify significant demographic, COVID-related, and socioeconomic factors associated with mental health outcomes. Results. Based on DASS-21 scores, the prevalence of depression, anxiety, and stress was 46.6% (mild: 22.3%, moderate: 16.7%, severe: 6.5%, and extremely severe: 1.1), 42.1% (mild: 10.2%, moderate: 18.6%, severe: 11.6%, and extremely severe: 1.7%), and 39% (mild: 16.7%, moderate: 12.7%, and severe: 9.6%), respectively. Various factors associated with COVID-19, its lockdown measures, and sociodemographic characteristics of the people were identified as the significant predictors of depression, anxiety, and stress among the general population of Nepal. Conclusion. The impact of COVID-19 lockdown on individuals’ work, income, education, living standard, lifestyle, and consequently mental health is significant. The study findings warrant the importance of understanding the impact of the COVID-19 pandemic on individuals’ all aspects of life and timely monitoring and appropriate intervention on risk groups to reduce the severity and chronicity of mental health problems.

During the COVID-19 lockdown, professional soccer players ceased their regular team training sessions and were provided with exercise programs to follow independently. This investigation assessed the impact of a 7-week COVID-19 lockdown and home-based individual physical training on professional soccer players’ body composition and physical fitness. The study consisted of nineteen division 1 elite soccer players (age 27.68 ± 5.99 years, height 178.47 ± 5.44 cm) and compared the anthropometric and physical fitness parameters obtained post-transition period to those obtained post-COVID-19 lockdown. The statistical analysis indicated that body fat percentage was significantly higher after the lockdown period [t(18) = -5.59, p < 0.01, d = 0.56]. Furthermore, VO2max [t(17) = -11.54, p < 0.01, d = 0.57] and running time [t(17) = 3.94, p < 0.01, d = 0.76] values were significantly higher after the COVID-19 lockdown than those obtained after the transition period. In addition, significantly higher level of performance was demonstrated on squat jump [t(18) = -4.10, p < 0.01, d = 0.30], countermovement jump [t(18) = -7.43, p < 0.01, d = 1.11] and sit and reach tests [t(19) = -5.33, p < 0.01, d = 0.32]. Concurrently, lower body strength was indicated to be significantly greater (p < 0.01) following the COVID-19 lockdown. The training protocol provided during the confinement, due to the COVID-19 outbreak, was effective in keeping physical fitness at a significantly higher level compared to the transition period. Coaches and trainers are encouraged to examine the effectiveness of this protocol, as it may help them develop effective periodization programs during the transition period. This protocol may aid in the development of effective periodization programs that require minimal equipment and can be followed in similar situations.

BACKGROUND: The lockdown would become the primary strategy for facing covid-19 as it quickly mutates which might cause repeated pandemics; however, it negatively affects individuals’ quality of life (QOL). The schizophrenia caregivers experience considerable stress. The research on the impact of the COVID-19 lockdown on QOL of schizophrenia caregivers is essential, especially for those who reside in rural areas. AIM: This study aimed to investigate the impact of lockdown-related COVID-19 on QOL among primary caregivers of schizophrenia patients living in a rural area. METHODS: This study recruited 204 primary caregivers (15–79 years). This study used the World Health Organization Quality of Life instrument (WHOQOL-BREF) to asses QOL’s primary caregiver. Evaluate the possible change in caregivers’ QOL before and during the COVID-19 lockdown using paired t-test for repeated measures. RESULTS: The mean age of the caregivers was 46.61 years (SD = 12.79), ranging from 15 to 79 years, with a preponderance of male (54.5%), aged 38–47 years old (29.7%), married (81.2%), employed (57.4%), and had senior high school level of education (34.7%). Majority were parents (26.2%) of the ill relative, and took care of the patients more than 5 years (52.5%). There was a statistical difference (p &lt; 0.05) in caregivers’ QOL between before and during the COVID-19 lockdown, including in physical health, psychological, social relationships, and environment domain. CONCLUSION: Implementing a lockdown policy related to COVID-19 has negatively impacted the caregivers’ QOL. The degradation of caregivers’ QOL showed from before to during COVID-19 lockdown. Further study needs to explore the QOL of other mental illness caregivers regarding COVID-19 lockdown. This finding becomes a reference for a government to modify some policy-related lockdowns to minimize their negative impact.

Purpose:To study the impact of the COVID-19 lockdown on the regular follow-up of keratoplasty patients.Methods:This retrospective interventional case series included 30 patients who had immunological corneal endothelial rejection out of 190 patients who came for post-PKP follow-up between September 15, 2019, and September 30, 2020. The demographics, primary diagnosis, surgical technique, time of presentation, recovery of graft, associated ocular problems, and visual acuity at 1 month were analyzed. Forward stepwise (likelihood ratio) binary logistic regression was used to find significant variables.Results:The study population had 19 males (63.33%) and 11 females (36.67%). The mean age of the study group was 42.83 ± 18.89 (8–80) years. Of 30 patients, 19 (63.3%) presented before and 11 (36.7%) after the COVID-19 lockdown. Overall, 23 (77%) showed a reversal of graft rejection. Logistic regression showed that preoperative indications, large-sized grafts, and deep corneal vascularization were significant risk factors for non-resolution of graft rejection. It was noted that patients who presented to the hospital late had poor recovery (P = 0.002). The delay in the presentation was a significant risk factor for non-resolution of graft rejection (P < 0.01). Z-test for proportions revealed that the difference in the non-resolution of rejection on immediate or delayed treatment in patients presenting during lockdown (P = 0.002) was significant.Conclusion:This article is to highlight the impact of the COVID-19 lockdown on graft rejection recovery of PKP patients due to delays in follow-up. Early treatment helps in the recovery of graft transparency and the reversal of immunological graft rejection. Also, primary diagnosis, deep vascularization, and large-sized grafts were significant risk factors for non-resolution of graft rejection.

Background Lockdowns and restrictions were introduced worldwide by governments in 2020 and 2021 in a bid to contain the spread of COVID-19. Lockdowns restricted the movement of people, whereby they could only leave their homes for essential reasons. There is yet to be a systematic review that integrates existing quantitative literature on the impact of lockdowns on mental health globally. Aim The purpose of the current study was to assess and synthesise current quantitative research on the global impact of COVID-19 lockdowns and isolation restrictions on adult mental wellbeing. The target group was adults aged 18 years and over internationally. Method Findings from 16 quantitative cross-sectional surveys and questionnaire studies from peer-reviewed journals were synthesised in this systematic literature review. Results Themes that emerged from the findings included increased depression, anxiety symptoms, and stress, and reduced social interaction and sleep quality. Conclusion The impact of COVID-19 lockdowns on mental health was evident through the shared experiences of insomnia, loneliness, physiological changes, and reduced sleep quality. An increased prevalence of depression, anxiety, and stress symptoms was common in younger adults and more so in women than men.

BackgroundDuring the first UK COVID-19 lockdown, studies identified over half of inflammatory arthritis (IA) patients in the UK reported a worsening of emotional distress. Given the prolonged nature of the pandemic, and the strict ‘shielding’ restrictions imposed on ‘extremely clinically vulnerable’ populations, it is likely that the implementation of the second lockdown period in England, during November 2020, may also have had a negative impact on the mental health of IA patients. The aim of this study was to qualitatively explore the impact of consecutive lockdown periods on mental wellbeing in people with IA.MethodsNine IA patients took part in semi-structured telephone interviews at both baseline (June/July 2020) and follow-up (November 2020). The interview schedule, which was developed and piloted with a Patient Research Partner, explored patient experiences and mental health impacts of the COVID-19 lockdown periods. Interviews were analysed using inductive thematic analysis.ResultsFive males and four females, with rheumatoid arthritis, psoriatic arthritis, or spondylarthritis, aged between 24–79 years (mean = 49.9, SD = 20.9) were included in the sample. Four main themes impacting on mental wellbeing were identified from the data: (1) Pandemic fatigue versus pandemic acclimatisation, (2) Social interaction and isolation, (3) Clarity of information, (4) Seasonal changes.ConclusionThe first two COVID-19 lockdown periods in England had an ongoing impact on the mental health of patients with IA. Healthcare professionals, in conjunction with government support, should ensure that adequate information and mental health resources are available to support IA patients during periods of ongoing restrictions, whilst also continuing to encourage behaviours which promote good mental health and wellbeing.

With the sudden change of environment and limited studies on the effects of COVID-19 lockdown among university students, this study therefore aims to examine the effects of COVID-19 lockdown on physical activity level and mental health among university students in Malaysia. This is a cross-sectional study involving university students studying in Klang Valley, Malaysia. Demographics information, living status during COVID-19, physical activity level and mental health status were obtained through online questionnaire via Microsoft forms. Paired T-test was used to compare the effect of physical activity level and mental health status during COVID-19 lockdown. Data on falls was available for 383 participants with 254 (66.3 %) women and 129 (33.7%) men. Overall, the metabolic equivalent task (MET) of vigorous, moderate, mild, and total MET has decreased during COVID-19 lockdown as compared to before COVID-19 lockdown. Approximately an increment of 6% of participants reported having depression and anxiety during COVID-19 lockdown. In conclusion, significant impact on physical activity level and mental health was found in our study. Our study findings could therefore assist educational institutions and policymakers in forming strategies to improve student’s overall health, yet further longitudinal studies should be performed to examine the long-term effects of COVID-19 lockdown. Keywords: Pandemic; students; sedentary; depression; anxiety

UK COVID-19 lockdowns significantly affected primary care access and delivery. Little is known about whether lockdowns disproportionally impacted vulnerable groups, including people who misuse substances, people who have experienced domestic violence or abuse, those with intellectual disability, and children with safeguarding concerns. To evaluate the impact of UK COVID-19 lockdowns on primary care contact rates among vulnerable groups. Natural experimental design using all registered patients in the OpenSAFELY platform. With approval from NHS England, we conducted controlled interrupted time-series analyses on records from 24 million patients in England between September 2019 and September 2021. Pre-pandemic, primary care contact rates were 110.1 per 1000 patients per week. Following the initiation of the first lockdown (23 March 2020), there was a large reduction of 29-61 contacts per 1000 patients per week among vulnerable and general population groups. For patients with alcohol misuse, those aged ≥14 years with intellectual disability, and children with safeguarding concerns, this reduction was significantly more extreme than corresponding general populations (relative rate difference -23.8 [95% confidence interval {CI} = -39.8 to -7.7, P = 0.003], -24.6 [95% CI = -38.8 to -10.5, P<0.001], and -15.4 [95% CI = -26.9 to -3.8, P = 0.009], respectively). Following the final lockdown (29 March 2021), all groups had contact rates exceeding pre-pandemic rates (with increases more marked in vulnerable populations), except those only including children. Our results suggested a larger short-term impact of the first COVID-19 lockdown on primary care contact for some vulnerable groups, compared with the general population, and differential impacts persisted through subsequent lockdowns and beyond for some vulnerable groups. There is a need to examine drivers of these differences to enable more equitable primary care access and provision.

Introduction: Social media use among children and adolescents has increased significantly especially when COVID-19 struck. Social media have appearance-related content that include images of which encourage appearance comparisons. Research suggests that media use among adolescents can affect their body image. Objective: This study aimed to identify the sociodemographic background among adolescents, the impact of COVID-19 lockdown on social media usage and body image and the association between social media usage and body image among adolescents in Kuantan, Pahang. Methods: A quantitative cross-sectional study was conducted among 347 adolescents in Kuantan, Pahang from April to June 2022 through convenience sampling method. Data were collected by using Google Forms survey and printed questionnaire that was available in bilingual. Descriptive statistics and Pearson’s correlation test was used for the data analysis using SPSS version 27. Results: About 37.8% of adolescents stated that they spent more than four hours a day before lockdown and it increases to 48.1% for current use. This indicate that a slight increase in social media usage before and after the COVID-19 lockdown. There is no significant association between the social media usage and the body image evaluation among adolescents. Conclusion: The adolescents seem to have moderate usage of social media and low body esteem.

Physical activity (PA) motives are associated with both moderate-to-vigorous intensity PA (MVPA) and mental health. Studies examining whether PA motives relate directly to mental health or indirectly through MVPA are lacking. This study examined the direct effect of five PA motives (i.e., enjoyment, competence, fitness, social, appearance) on mental health and their indirect effects through MVPA in adolescents. A total of 424 participants (57.1% females) ages 14-15 years from the longitudinal MATCH study were included. Mediation analyses, based on the counterfactual framework, assessed the natural direct effect of PA motives on mental health, and the natural indirect effects through MVPA. Separate models were conducted for each PA motive. Natural direct effects were observed for enjoyment ( [95%CI]=2.12 [0.34, 3.90]), competence ( [95%CI]=1.58[0.28, 2.88]), fitness ( [95%CI]=1.42[0.04, 2.80]), and social ( [95%CI]=2.32[1.03, 3.60]) motives. No natural direct effects were observed for appearance motives. A natural indirect effect through MVPA was observed for fitness motives, and no other natural indirect effects were found. Interventions and public health strategies in adolescents need to acknowledge the importance of enjoyment, competence social and fitness motives in PA to promote mental health, and integrate specific recommendations on the importance of the reasons why adolescents participate in PA.

COVID-19 has changed the daily lives of citizens around the world and exposed the vulnerability of life and the functioning of cities. The pandemic has forced citizens to adapt to new models of remote work during quarantine and access to smart technology-based services. The article aims to assess citizens' perceptions of the technological solutions provided by smart cities and, in particular, the municipality of Paphos before and after the Covid-19 pandemic, as well as to evaluate their impact on citizens' mental health. The results of the study contribute to the understanding of the mental health benefits for citizens living in smart cities compared to people living in low-tech areas, revealing the potential positive effects of smart technologies, as well as the change in people's digital decision-making before and after the pandemic

The COVID-19 outbreak led to a fresh and urgent interest in how to manage the effect of extraordinary public health actions on the mental health of individuals. In this study, we focused on the impact of the COVID-19 lockdown on the mental well-being of parents. We adopted a broad perspective, considering, among others, parents' risk of developing common mental disorders and their propensity to take steps to manage their mental health. Our results supported the findings that modification in lifestyle can lead to improvement in mental health. In light of the renewal of lockdown measures, there is a need for more studies to address the confusion and concern facing families. (Morelli et al.2020) Rapid large-scale public health interventions intended to limit the spread of the coronavirus not only led to concern about the potentially less severe complications but also garnered a fresh and urgent interest in how to manage the effect of extraordinary public health actions on the mental health of individuals. In this study, we attempted to shed light on the impact of the COVID-19 lockdown on the mental well-being of parents. The focus was on parents as they are more likely to have experienced significant emotional and practical pressure as a result of lockdown. Keywords: Statistics, Analytics, Covid-19, Mental health

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.

Background: The COVID-19 pandemic lockdowns have adversely impacted children on the autism spectrum and their families, especially in Malaysia where this population is often marginalized. The current quantitative research aimed to investigate the impact of the Malaysian COVID-19 lockdown on the behavior and psychological distress of children formally diagnosed with an autism spectrum condition (ASC) as well as the psychological distress and well-being of their parents, in comparison with a typically developing (TD) control group.Methods: The children's ages ranged between 5 and 17 years. The sample included 72 ASC parent-child dyads and 62 TD parent-child dyads. The primary caregiver completed an online survey including the following: demographic and diagnostic information; ASC symptoms; children's inattention, hyperactivity/impulsivity, perceived stress, depression, and anxiety; parents' perceived stress, depression, anxiety, and well-being based on their experience pre- and mid-lockdown (March 18th to June 9th 2020) in Malaysia.Results: Among the ASC group, no significant pre- and mid-lockdown change was found in ASC symptoms (p > 0.05). There were no significant gender differences (boys/girls) in all the child scales. The 2 [diagnosis (ASC, TD)] × 2 [lockdown (pre-lockdown, mid-lockdown)] mixed-model ANOVAs revealed main effects of lockdown on children's attention, hyperactivity/impulsivity, anxiety, and parents' perceived stress, depression, and psychological well-being (p < 0.005). There was a main effect of diagnosis in all child and parent variables, except parents' perceived stress (p >0.005). However, there was no significant interaction effect between diagnosis and lockdown (p >0.005). All child behavior (inattention and hyperactivity/impulsivity) and child psychological distress (anxiety, depression, and perceived stress) were significantly correlated in both the ASC and TD groups (p < 0.005). On the other hand, only some of the parent variables were significantly correlated with child variables (p < 0.0045) in the ASC group while none of the parent variables were significantly correlated with the child variables (p > 0.005) in the TD group.Conclusion: The results provide preliminary evidence indicating negative effects of the Malaysian lockdown on both children on the autism spectrum and TD children, as well as their parents. These quantitative results will be triangulated with the qualitative interview data to provide a holistic understanding of the impact of the pandemic, informing translational policy and practice recommendations.

Prior to the COVID-19 pandemic, we demonstrated the efficacy of a novel Cognitive Behavioural Therapy programme for the treatment of Non-Rapid Eye Movement Parasomnias (CBT-NREMP) in reducing NREM parasomnia events, insomnia and associated mood severities. Given the increased prevalence and worsening of sleep and affective disorders during the pandemic, we examined the sustainability of CBT-NREMP following the U.K.'s longest COVID-19 lockdown (6 January 2021-19 July 2021) by repeating the investigations via a mail survey in the same 46 patient cohort, of which 12 responded. The survey included validated clinical questionnaires relating to NREM parasomnia (Paris Arousal Disorder Severity Scale), insomnia (Insomnia Severity Index) and anxiety and depression (Hospital Anxiety and Depression Scale). Patients also completed a targeted questionnaire (i.e., Impact of COVID-19 Lockdown Questionnaire, ICLQ) to assess the impact of COVID-19 lockdown on NREM parasomnia severity, mental health, general well-being and lifestyle. Clinical measures of NREM parasomnia, insomnia, anxiety and depression remained stable, with no significant changes demonstrated in questionnaire scores by comparison to the previous investigatory period prior to the COVID-19 pandemic: p (ISI) = 1.0; p (HADS) = 0.816; p (PADSS) = 0.194. These findings support the longitudinal effectiveness of CBT-NREMP for up to three years following the clinical intervention, and despite of the COVID-19 pandemic.