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Background COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020, and as of this writing, Texas, United States, has reported >675,000 cases with over 14,000 deaths. Many of the preventive measures implemented during the pandemic can increase sedentary lifestyles, which can lead to the development of chronic diseases, including obesity, among the general population and cause serious threats to people’s physical health and overall quality of life. Individuals with pre-existing comorbidities are at an increased risk of COVID-19 and may hence have higher levels of stress. Objective This study aimed to investigate the relationship between physical activity levels and mental health status on an individual level and to compare them between those with and those without comorbidities in a cohort of Texas residents, before and after COVID-19 was declared a pandemic. Methods An electronic survey was disseminated throughout various regions of Texas. In total, 160 individuals were asked questions about their demographic characteristics, time spent on daily physical activities, and daily mental health status before and after COVID-19 was declared a pandemic. Frequency distributions and descriptive statistics were analyzed. Results Overall, 94 (58%) participants reported having ≥1 medical condition, and 31 (13.1%) had >3 medical conditions. Physical activity levels among participants with ≥1 pre-existing comorbidity drastically—but not significantly—decreased, as evident from a 10% increase in sedentary lifestyles after COVID-19 was declared a pandemic. On the contrary, we observed a 9% increase in the number of individuals without a pre-existing comorbidity who reported 30-60 min of physical activity per week. There was a 2-fold increase in the number of participants reporting more frequent feelings of nervousness, too much worry, trouble relaxing, and the fear of something awful happening after the pandemic. More specifically, individuals with pre-existing medical conditions reported, on average, a 10% higher incidence of feelings of stress, anxiety, and sadness compared to their healthy counterparts after COVID-19 was declared a pandemic. Conclusions Stressful life conditions and chronic comorbidities are risk factors that can affect mental health and reduce the ability to perform activities of daily life. Therefore, when implementing pandemic protocols, municipalities should consider providing mental health support to their citizens to protect them from this rather inconspicuous adverse effect.

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BACKGROUND Coronavirus disease-19 (COVID-19) was declared a global pandemic by the World Health Organization (WHO) on March 11, 2020 and currently in the state of Texas, USA, there are more than 675,000 cases with 14,000 deaths. Many of these implementations can increase sedentary lifestyles. which can lead to the development of chronic diseases, obesity development among the population and overall cause serious threats to people’s physical health and lives. Individuals with pre-existing conditions are at increased risk of contracting COVID and thus may have higher levels of stress. OBJECTIVE Explore the relationship between individual’s level of physical activity and status of mental health, on individuals with health conditions versus those with none, before and after COVID-19 was declared a pandemic for the citizens of Texas. METHODS An electronic survey was disseminated throughout various regions of Texas. 157 respondents were asked questions about their demographics, time spent on daily physical activities, and daily mental health status before and after COVID-19 was declared a pandemic. Frequency distribution and descriptive statistics was performed. RESULTS 61% of participants reported having 1 or more health conditions with 13.6% of the respondents having 3+ medical conditions. These same individuals reported a 10% increase in 0-30 mins of daily activity after the pandemic declaration compared to a 10% increase in healthy individuals. There was a 2-fold increase in the number of participants reporting more frequent feelings of nervousness, worrying too much, having trouble relaxing and feeling afraid something awful might happen after the pandemic. More specifically, individuals with pre-existing medical conditions reported on average a 10% higher incidence of feelings of stress, anxiety and sadness compared to healthy counterparts after the pandemic declaration. CONCLUSIONS Stressful life conditions and having a chronic disease are risk factors that can affect mental health and reduce the ability of proper daily functioning. Therefore, when implementing pandemic protocols, municipalities should consider providing mental health support to their citizens to protect them from this invisible adverse effect.