Lifestyle changes, mental health, and health-related quality of life in children aged 6–7 years before and during the COVID-19 pandemic in South Germany

Abstract

Background The measures against the COVID-19 pandemic are challenging for children and parents, and detrimental effects on child health are suggested especially from lock-down measures and school closings. Methods We conducted a cross-sectional analysis using a population based longitudinal (birth-) cohort study (SPATZ study) conducted in the South of Germany. Data included all 6 or 7 year old children for whom a questionnaire was completed during first grade of school. Consequently, we were able to analyze children being in first grade before the first lockdown in Germany (≤ 15th March 2020), as well as children being in first grade during the pandemic (> 15th March 2020). We conducted descriptive statistics and estimated the associations between the two time periods, before and during the pandemic, and various outcomes of child health using multivariable adjusted linear or logistic regression modeling. The analysis was stratified by gender. Results Results among n = 362 children aged six or seven years showed substantially lower mean scores of health-related quality of life (difference in means: − 5.5, 95% confidence interval (CI) − 9.0, − 2.0), and higher mean scores in total emotional and behavioral difficulties (difference in means: 2.0, 95% CI 0.2, 3.8) in girls during vs. before the COVID-19 pandemic using multivariable linear regression modeling. In addition, weekly screen-time was increased in boys by 3.5 h (95% CI 0.6, 6.4). We did not find substantial differences in sleep quality, physical activity, and time spent with books, neither in boys nor in girls, however, the limited sample size has to be considered. Conclusion Child health (and behavior) of first grade school children is possibly impacted by the COVID-19 pandemic with adverse consequences possibly differing by gender.

The Potential Impact of COVID-19 on Health-Related Quality of Life in Children and Adolescents: A Systematic Review

“…The eight studies selected for this study were evaluated to ensure they met one to three of these criteria. Of the eight criteria, two studies (25.0%) met one [ 22 , 23 ], three studies (37.5%) met two [ 24 , 25 , 26 ], and three studies (37.5%) met three ( Table 1 ) [ 27 , 28 , 29 ].…”

“…Analysis of the studies on HRQoL by age group showed that four (50.0%) targeted early to late adolescents [ 22 , 23 , 25 , 29 ], three (37.5%) targeted respondents from middle childhood to early adolescence [ 24 , 26 , 27 ], and one (12.5%) targeted only respondents in middle childhood [ 28 ]. Analysis of respondents revealed that one study used responses from parents (12.5%), three studies collected responses from children and adolescents (37.5%), and four studies collected responses from adolescents only (50.0%) ( Table 2 ).…”

“…Studies in the United States and Spain compared the HRQoL of children and adolescents before and after COVID-19 quarantines [ 24 , 26 ]. Studies conducted in southern Germany and the United States compared the HRQoL of children and adolescents before and during the pandemic [ 25 , 28 ]. Studies comparing the HRQoL of children and adolescents at one time point during the pandemic were conducted in France, the United States, and Norway ( Table 3 ) [ 22 , 23 , 27 , 29 ].…”

“…The frequency analysis of these measurement tools for children and adolescents revealed that the distribution of measurements for evaluation was as follows. Three studies (37.5%) used the PedsQL [ 22 , 25 , 27 , 29 ], three studies (37.5%) used either KIDSCREEN-10 [ 23 , 26 ] or KIDSCREEN-27 [ 27 ], one study (12.5%) used KINDL-R [ 28 ], and one study (12.5%) used the CPQ11–14 [ 24 ] ( Table 3 ).…”

“…When each study was compared according to their focus on gender, we found that five (62.5%) reported differences in HRQoL according to gender [ 23 , 25 , 26 , 27 , 28 ], while the remaining three (37.5%) did not [ 22 , 24 , 29 ]. For example, Kurz et al reported that changes in HRQoL before and during the pandemic differed by gender [ 28 ]. Bourion-Bédès et al compared the quality of life of children and adolescents by gender [ 27 ].…”