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Reduced Physical Activity During COVID-19 in Children With Congenital Heart Disease: A Longitudinal Analysis
Mimi T Y Kuan1, Nicole M Hemphill1, Kevin C Harris1
1Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
Insights
The COVID-19 pandemic significantly reduced physical activity in children with congenital heart disease (CHD), worsening their cardiovascular risk. Targeted interventions are crucial to improve their health outcomes during the ongoing pandemic.
Area of Science:
- Pediatric Cardiology
- Public Health
- Exercise Science
Background:
- Children with congenital heart disease (CHD) face elevated cardiovascular risks.
- The COVID-19 pandemic has been linked to decreased physical activity in children.
- Optimizing cardiovascular health behaviors is critical for this vulnerable population.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on longitudinal physical activity in children with CHD.
- To understand changes in daily step counts and seasonal activity patterns.
Main Methods:
- A prospective cohort study involving 102-114 children and adolescents (aged 9-16) with moderate-to-complex CHD.
- Continuous 3-year (2018-2021) daily step count monitoring using Fitbit Charge 2.
- Parent/self-report surveys assessed school status during the pandemic.
Main Results:
- A significant reduction in annual mean step count was observed in 2020 (8225 steps) compared to 2018 (9416 steps) and 2019 (9533 steps) (P < 0.001).
- Physical activity levels decreased significantly, with a notable loss of seasonal variation.
- Reduced activity persisted even after children returned to in-person schooling in September 2020.
Conclusions:
- The COVID-19 pandemic led to a significant decrease in physical activity and loss of seasonal patterns in children with CHD.
- These findings indicate an increased cardiovascular risk profile for children with CHD.
- Urgent mitigation strategies are required to enhance cardiovascular health in this population amidst the pandemic.
Background:
Coronavirus disease 2019 (COVID-19) was associated with a reduction in physical activity in children with congenital heart disease (CHD) in early 2020. Given the increased cardiovascular risk of this population, optimizing cardiovascular health behaviour is important. The aim of the study is to determine how the ongoing COVID-19 pandemic has impacted longitudinal physical activity measures in children with CHD.
Methods:
As part of a prospective cohort study, children and adolescents aged 9-16 years old with moderate-to-complex CHD were recruited from British Columbia Children's Hospital and partnership clinics across British Columbia and the Yukon territory. Daily step counts were measured continuously over 3 years (2018-2021) with Fitbit Charge 2. School status during the COVID-19 pandemic was assessed with parent- or self-report survey.
Results:
A total of 102, 114, and 93 participants had valid Fitbit data during 2018, 2019, and 2020, respectively. There was a significant reduction in the annual mean step count for 2020 (8225 ± 4328 steps) compared with both 2018 (9416 ± 3770 steps) and 2019 (9533 ± 4114 steps) (P < 0.001). There was a loss of seasonal variation in physical activity, and reduced levels of physical activity persisted when most children resumed in-person schooling in September 2020.
Conclusions:
We demonstrated a significant decrease in physical activity and loss of seasonal patterns in children with CHD during 2020. These findings represent a worsening of the cardiovascular risk profile in children with CHD, who are already at an increased risk of adverse cardiovascular outcomes. Mitigation strategies are needed to optimize the cardiovascular health status of children with CHD as the pandemic persists.
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