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

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.