High School Sports During the COVID-19 Pandemic: The Effect of Sport Participation on the Health of Adolescents

Abstract

Context: During the fall of 2020, some high schools across the US allowed their students to participate in interscholastic sports while others cancelled or postponed their sport programs due to concerns regarding COVID-19 transmission. It is unknown what effect this has had on the physical and mental health of adolescents. Objective: Identify the impact of playing a sport during the COVID-19 pandemic on the health of student athletes. Design: Cross-sectional study. Setting: Sample recruited via email. Patients or Other Participants: 559 STATE-XXX high school athletes (age=15.7±1.2 yrs., female=44%) from 44 high schools completed an online survey in October 2020. A total of 171 (31%) athletes played (PLY) a fall sport, while 388 (69%) did not play (DNP). Main Outcome Measure(s): Demographics included: sex, grade and sports played. Assessments included the General Anxiety Disorder-7 Item (GAD-7) for anxiety, Patient Health Questionnaire-9 Item (PHQ-9) for depression, the Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and the Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. Univariable comparisons between the two groups were made via t-tests or chi-square tests. Means for each continuous outcome measure were compared between the groups by ANOVA models that controlled for Age, Sex, Teaching method (Virtual, Hybrid, or In-person), and the % of students eligible for free lunch. RESULTS: PLY group participants were less likely to report moderate to severe symptoms of anxiety (PLY=6.6%, DNP=44.1%, p<0.001) and depression (PLY=18.2%, DNP=40.4%, p<0.001). PLY athletes reported higher (better) PFABS scores (mean: [95%CI]), (PLY=23.2[22.0,24.5], DNP=16.4[15.0,17.8], p <0.001) and higher (better) PedsQL total scores (PLY=88.4[85.9,90.9], DNP=79.6[76.8,82.4], p <0.001). CONCLUSIONS: Adolescents who played a sport during the COVID-19 pandemic reported fewer symptoms of anxiety and depression, as well as higher physical activity and quality of life scores compared to adolescent athletes who did not play a sport.

The Effect of COVID-19 Lockdown on PHQ Depression Screening Scores for High School Athletes

“…Consistent with trends noted in the recent literature, the timeline of the lockdown has been associated with declining mental health of this subgroup of adolescents [ 21 , 22 , 23 , 24 , 25 , 26 ]. Given the temporal sequencing of the PHQ depression screening results among the high school students and the mandated lockdown, it is logical that the increased rate of depression observed is associated with the pandemic.…”

“…Given that physical exercise has shown to be protective against depressive symptoms in adolescents [ 20 ], the loss of organized physical activity may have amplified the effects of the shutdown [ 21 , 22 ]. Limited studies have focused on student athletes, but research has shown the benefits of increased physical activity level, social interactions, and sports participation on overall mental health functioning [ 23 , 24 , 25 , 26 ].…”

A narrative review into the impact of COVID‐19 pandemic on senior high school adolescent mental health

“…Meanwhile, the risk factors that are positively related to high anxiety in adolescents are lack of rest, having difficulty with online education, having too much schoolwork, focusing too much on graduation, where adolescents live, and low physical activity (AlAzzam et al, 2021 ; Andreas & Brunborg, 2021 ; Liu et al, 2021 ). Adolescents who participate in sports activities have a lower risk of anxiety and depression than adolescents who do not do sports (McGuine et al, 2021 ). The residence of adolescents also can increase the risk of anxiety.…”

Minds matter: how COVID-19 highlighted a growing need to protect and promote athlete mental health

“…In particular, social isolation (eg, with team and tournament ‘bubbles’), concerns about well-being and financial problems, a fear of body changes with altered training and dietary regimens, as well as uncertainty about their identity, career and future, have been mentioned as COVID-19-specific mental health contributing factors 3–5 8. Loss of athlete motivation, meaning and identity may have also perpetuated depressive symptoms in athletes, especially for those exposed to competition postponement 9…”