Background: The benefits of sport participation and physical activity within adolescent populations has been well established, including improved physical and psychological health, social functioning, and sleep quality.1-3 However, mandated stay-at-home orders during the COVID-19 pandemic resulted in an abrupt cessation of school and sport participation for many adolescent athletes. This sudden suspension of sports, physical activity and peer/social interaction may have negative implications on adolescent anxiety and fatigue, as well as peer relationships and sleep quality. Purpose: (1) Compare quality of life and sleep quality measures in adolescent athletes during the COVID-19 pandemic to measures obtained 1-2 years earlier. (2) Assess physical activity and social interaction behavior during the two weeks prior to school closure compared to a two-week period during school closure. Methods: Participants first completed Patient Reported Outcome Measurement System (PROMIS) anxiety, fatigue, and peer relationship short forms, and the Pittsburg Sleep Quality Inventory (PSQI) during pre-participation sport physical evaluations (May 2018 or 2019), and again during May or June (2020). Physical activity and social interaction were assessed at the second timepoint by asking participants to retrospectively report behaviors during the two weeks prior to school closure, and during the two weeks preceding questionnaire completion. We compared outcomes using paired samples t-tests (continuous outcome variables) and McNemar`s test (categorical outcome variables). All statistical tests were two-sided and evaluated at a significance level of a = 0.05. Results: A significant portion (92%) of participants (n=39; 16.2±0.9 years of age; 64% female; 499±177 days between assessments) reported sport cessation due to COVID-19 (Table 1). Compared to pre-COVID assessments, participants reported significantly higher anxiety and fatigue scores, and significantly worse sleep quality after school and sport cessation (Figure 1). Physical activity frequency and duration were significantly reduced in the two weeks prior to questionnaire completion compared to the two weeks before sport and school closure (Table 2). No significant difference was found for quality of peer relationships (Figure 1), although characteristics of peer/social interactions differed significantly between timepoints. Conclusion: Following recent stay-at-home orders, high school athletes reported more anxiety and fatigue, worse sleep quality, and less physical activity compared to assessments obtained in the Spring of 2018 or 2019. The abrupt cessation of school and sport participation due to COVID-19, in combination with other life factors, likely contributed to reductions in physical activity, worse sleep quality, changes in social interaction, elevated levels of anxiety, and increased fatigue among high school athletes.
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