Physical Activity, Screen Time, and Emotional Well-Being during the 2019 Novel Coronavirus Outbreak in China

Abstract

We aimed to evaluate the effects of the COVID-19 lock down on lifestyle in China during the initial stage of the pandemic. A questionnaire was distributed to Chinese adults living in 31 provinces of China via the internet using a snowball sampling strategy. Information on 7-day physical activity recall, screen time, and emotional state were collected between January 24 and February 2, 2020. ANOVA, χ² test, and Spearman's correlation coefficients were used for statistical analysis. 12,107 participants aged 18-80 years were included. During the initial phase of the COVID-19 outbreak, nearly 60% of Chinese adults had inadequate physical activity (95% CI 56.6%-58.3%), which was more than twice the global prevalence (27.5%, 25.0%-32.2%). Their mean screen time was more than 4 hours per day while staying at home (261.3 ± 189.8 min per day), and the longest screen time was found in young adults (305.6 ± 217.5 min per day). We found a positive and significant correlation between provincial proportions of confirmed COVID-19 cases and negative affect scores (r = 0.501, p = 0.004). Individuals with vigorous physical activity appeared to have a better emotional state and less screen time than those with light physical activity. During this nationwide lockdown, more than half of Chinese adults temporarily adopted a sedentary lifestyle with insufficient physical activity, more screen time, and poor emotional state, which may carry considerable health risks. Promotion of home-based self-exercise can potentially help improve health and wellness.

Keywords: COVID-19; lockdown; physical activity; psychological impact; screen time; sedentary lifestyle.

Figure 1

Prevalence of insufficient physical activity (PA) among Chinese adults aged 18 and over during COVID-19 epidemic period in China, compared with the national levels in China (during non-epidemic period) and the average global level (World Health Organization (WHO) data, without COVID-19 outbreak), among all participants, men, and women, separately. PA = physical activity. * p < 0.05 versus Global level; ^& p < 0.05 versus China without COVID-19 outbreak (non-epidemic period).

Figure 2

Provincial proportions of insufficient physical activity during home quarantine induced by COVID-19 for 31 provinces in mainland China. A: both sexes; B: men; C: women. BJ = Beijing. TJ = Tianjin. HE = Hebei. SX = Shanxi. NM = Inner Mongolia. LN = Liaoning. JL = Jilin. HL = Heilongjiang. SH = Shanghai. JS = Jiangsu. ZJ = Zhejiang. AH = Anhui. FJ = Fujian. JX = Jiangxi. SD = Shandong. HA = Henan. HB = Hubei. HN = Hunan. GD = Guangdong. GX = Guangxi. HI = Hainan. CQ = Chongqing. SC = Sichuan. GZ = Guizhou. YN = Yunnan. XZ = Tibet. SN = Shaanxi. GS = Gansu. QH = Qinghai. NX = Ningxia. XJ = Xinjiang. TW = Taiwan. HK = Hong Kong. MO = Macao. WH = Wuhan. WZ = Wenzhou.

Figure 3

Screen time among Chinese residents aged 18 years and over during home quarantine induced by COVID-19, 2020. (A): Comparisons in screen time by sex, urban or rural residence, and physical activity level. (B): Comparisons in screen time by age. PA = physical activity. ^& p < 0.05 versus Urban; * p < 0.05 versus Vigorous level; ^# p < 0.05 versus Moderate level; ^a p < 0.05 versus 20–24; ^b p < 0.05 versus 25–29. All values were presented as mean ± SD.

Figure 4

Scatterplots showing correlations between provincial levels of lifestyle and emotional state and provincial proportions of confirmed COVID-19 cases in 31 provinces of mainland China, 2020. (A): insufficient physical activity; (B): screen time; (C): positive affect scores; (D): negative affect scores. Proportion of COVID-19 cases was calculated by dividing the total number of confirmed COVID-19 cases (until 3 February 2020) by the number of total population (by the end of 2018) in each of 31 provinces. Populations at the end of 2018 in different provinces are cited from the China Statistical Yearbook published by the National Bureau of Statistics of China (2019).