A Multi-year Assessment of Sport Participation During the COVID-19 Pandemic on the Health of Adolescent Athletes.

ABSTRACT

CONTEXT Sport cancellations early in the COVID-19 pandemic had a significant negative impact on the health of US adolescents. The impact of restarting sports during the COVID-19 pandemic has not been described. OBJECTIVE: To identify the impact of sport participation on the health of adolescents before and during the COVID-19 pandemic. DESIGN: Cross-sectional study. SETTING: Sample recruited via social media. PATIENTS OR OTHER PARTICIPANTS: Wisconsin adolescent athletes. MAIN OUTCOME MEASURE(S) Participants provided information regarding their age, sex, sports participation and completed the Patient Health Questionnaire-9 Item (PHQ-9) to assess depressive symptoms, the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS-PFABS) to measure physical activity (PA) and the Pediatric Quality of Life Inventory 4.0 (PedsQL) to measure Quality of Life (QoL). METHODS: Data were collected in spring 2021 (Spring21) (n=1906 age=16.0±1.2, female=49%), when interscholastic sports had fully resumed, and were compared to similar cohorts of adolescent athletes at two different time points that included 1) spring 2020 (Spring20) (n=3243, age=16.2±1.2, female=58%), when sports were cancelled, and 2) 2016-2018 (PreCOVID-19) prior to the pandemic (n=5231, age=15.7±1.1, female=65%). Comparisons were made via ANOVA models and ordinal regressions with age and sex as covariates. RESULTS: The prevalence of moderate to severe depression was lower in Spring21 than Spring20, but higher than PreCOVID-19 (PreCOVID-19=5.3%, Spring20=37.8%, Spring21=22.8%, p<0.001). PA levels (mean [95%CI] were higher in Spring21 than Spring20 but lower than PreCOVID-19 (PreCOVID-19=23.1 [22.7, 23.5]), Spring20=13.5 [13.3, 13.7], Spring21=21.9 [21.6, 22.2]. Similarly, QoL scores were higher in Spring21 than Spring20 but lower than PreCOVID-19 (PreCOVID-19=92.8 [92.5, 93.1]) Spring20=80.7 [80.3, 81.1], Spring21=84.3 [83.8, 84.8]). CONCLUSIONS: Though sports have restarted, clinicians should be aware that physical activity, mental health, and QoL are still significantly affected by the ongoing pandemic in adolescent athletes.