The COVID-19 has undergone several mutations, and caused deleterious effects on physical and mental health of people worldwide. Whilst physical exercise is known for its positive effect on enhancing immunity and reducing the negative consequences of unhealthy emotional states caused by the pandemic; there is a severe lack of psychological exercise intervention measures and mitigation strategies to advance the knowledge and role of physical exercise to improve mental health in most countries. This study surveyed the association between physical exercise and mental health burden during the COVID-19 outbreak in China to better understand the influence of different physical exercise types on reducing mental health burden during the pandemic. ANOVA, binary logistic regression, the chi-square test, and Spearman's correlation analysis were used for statistical analysis. 14,715 participants were included. The results showed that Chinese residents had several poor mental health conditions during the COVID-19 outbreak. And there was a significant positive correlation between the extent of adverse effects on mental health and provincial proportions of confirmed COVID-19 cases (r = 0.365, p < 0.05). Some main factors caused an unhealthy psychological status, including epidemic severity (62.77%, 95% CI 58.62-65.64%), prolonged home quarantine (60.84%, 95% CI 58.15-63.25%), spread of large amounts of negative information about COVID-19 in the media (50.78%, 95% CI 47.46-53.15%), limitations in daily life and social interaction (45.93%, 95%CI 42.46-47.55%), concerns about students' learning (43.13%, 95% CI 40.26-45.48%), and worries about being infected (41.13%, 95% CI 39.16-45.23%). There was a significant association between physical exercise and mental health. The largest associations were seen for home-based group entertainment exercise (i.e., family games, rope skipping, and badminton), Chinese traditional sports (i.e., Chinese martial arts, Taijiquan and Qigong), and popular sports (i.e., yoga, video dancing, sensory-motor games, and whole-body vibration), as well as durations of 30-60 min per session, frequencies of three to five times per week and a total of 120-270 min of moderate-intensity exercise weekly during the COVID-19 outbreak (p < 0.05).

Background COVID-19 caused severe effects on the psychological well-being of Chinese students overseas (COS). Physical activity (PA) is critical to strengthen immunity, prevent infection, and reduce the psychological burden caused by COVID-19. However, there is a severe lack of effective PA intervention for mental health in most countries, and COS have limited access to mental healthcare during the pandemic. Objective We aim to examine the effects of PA on COS’ mental health during the pandemic abroad and to better understand that certain types of PA might be associated with a greater reduction in psychological burdens during the pandemic. Methods and results In a multi-country cross-sectional analysis, a questionnaire was distributed to COS living in 37 foreign countries via WeChat Subscription using a snowball sampling strategy. A total of 10,846 participants were included. Descriptive statistics and Binary logistic regression analysis were used for statistical analysis. We found that COS had negative psychology during the pandemic, especially with fear (2.90, 95% CI 2.88−2.92), anxiety (2.84, 95% CI 2.82−2.85), and stress (2.71, 95% CI 2.69−2.73). PA had meaningful effects on reducing COS self-reported mental health burdens (3.42, 95% CI 3.41–3.44) during the pandemic. The largest associations were seen for recreational and home-based PA (i.e., family games, home aerobic exercise), individual outdoor PA (i.e., walking or running, rope skipping), and PA with a duration of 30 to 70 min per session at frequencies of 4 to 6 times and a total of 150 to 330 min of moderate and vigorous intensity per week tends to be an optimal choice during social distancing times. Conclusions COS had several poor mental health conditions during the pandemic. The improvement of PA on COS’ psychology was positively effective during the pandemic. Specific types, intensities, durations, and frequencies of PA might have advantages over others for improving COS’ mental health during periods of public health emergencies, and the topic may merit interventional study to reveal multiple factors causing COS’ psychological burdens and enrich the PA forms for all COS’ mental health improvement (i.e., infected, recovered, and asymptomatic COS).

COVID-19 has undergone several mutations and is still spreading in most countries now. PA has positive benefits in the prevention of COVID-19 infection and counteracting the negative physical and mental effects caused by COVID-19. However, relevant evidence has indicated a high prevalence of physical inactivity among the general population, which has worsened due to the outbreak of the pandemic, and there is a severe lack of exercise guidance and mitigation strategies to advance the knowledge and role of PA to improve physical and mental health in most countries during the epidemic. This study surveyed the effects of COVID-19 on PA in Chinese residents during the pandemic and provided important reference and evidence to inform policymakers and formulate policies and planning for health promotion and strengthening residents' PA during periods of public health emergencies. ANOVA, Kolmogorov-Smirnov, the chi-square test and Spearman correlation analysis were used for statistical analysis. A total of 14,715 participants were included. The results show that nearly 70% of Chinese residents had inadequate PA (95%CI 58.0%-82.19%) during the COVID-19 outbreak, which was more than double the global level (27.5%, 95%CI 25.0%-32.2%). The content, intensity, duration, and frequency of PA were all affected during the period of home isolation, and the types of PA may vary among different ages. The lack of physical facilities and cultural environment is the main factor affecting PA. However, there was no significant correlation between insufficient PA and the infection rate. During the period of home isolation and social distance of epidemic prevention, it is necessary to strengthen the scientific remote network monitoring and guidance for the process of PA in China.Keywords COVID-19 Á Chinese residents Á PA Á Influence Á Home isolation Á Social distancing Á Health well-being Á PA guidance Yingjun Nie and Yuanyan Ma contributed equally to this work and share first authorship.

Background: COVID-19 caused serious mental health burden for international students. However, only several international students obtained related mental health services. The topic of international students' mental health has the bigger jump among social and educational concerns during the pandemic. This study surveyed the effects of COVID-19 on the mental health of Chinese overseas students to provide essential reference for identifying mental health problems of Chinese overseas students, so that they can be targeted for timely crisis-oriented and tailoring mental health interventions during periods of public health emergencies. Methods: Descriptive statistics such as percentages, 95% CIs, means and standard deviations were calculated to reflect the demographic characteristics of the survey population. The Kolmogorov-Smirnov test was used to test the normality of continuous variables. The chi-square test was used to determine the statistical significance of the differences in participants' mental health status. Binary logistic regression was used to analyze the factors influencing on Chinese overseas students' mental health. The data were analyzed through quantitative and qualitative methods. Results: Chinese overseas students had several poor mental health status during the COVID-19 pandemic. Furthermore, the degree of mental health burden might differ between countries, but there were not notable differences in gender (p = 0.75) and in ant-pandemic duration. Some main factors caused an unhealthy psychological status, including epidemic severity in residence（67.94%, 95% CI：67.06% — 68.82%）, fear of being infected（64.54%, 95% CI：63.72% — 65.36%）, worries of academic performance（62. 43%, 95% C%I：60.64% — 64.22）, infection control policies of the host government（58. 09%, 95% CI：57. 16% — 59. 01%）, epidemic preventive measures of locals（56. 03%, 95% CI：55. 10% — 56. 96%）, obstruction of return trips（54.85%, 95% CI：53.91% — 55. 79%）, mutation of the epidemic virus（53. 75%, 95% CI：52. 71% — 54. 79%）. Conclusions: The main conclusion of this research is that Chinese overseas students experience mental health burdens during the COVID-19 pandemic and they need timely psychological services, positive support, and tailoring guidance to better manage mental health in this unusual situation.