Lifestyle and quality of life in children and adolescents during the covid-19 social distancing period

Objective: To evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020.Methods: This cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student's t test, and the generalized estimating equation.Results: Mean screen time increased from 2h pre-pandemic to 5h during the pandemic (p < 0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 +/- 2.6 to 71.3 +/- 13.7, p < 0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 +/- 13.3 vs 72.80 +/- 13.4 vs 76.4 +/- 12.6; p < 0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 +/- 13.1 vs 74.5 +/- 13.1 vs 76.8 +/- 12.2; p < 0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 +/- 12.3 vs 72.5 +/- 14.4; p < 0.001). Children aged 2-4y old had the best QoLscores.Conclusions: Pandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.