Prevalence of Insufficient Physical Activity, Sedentary Screen Time and Emotional Well-Being During the Early Days of the 2019 Novel Coronavirus (COVID-19) Outbreak in China: A National Cross-Sectional Study

Background: The pandemic of 2019 novel coronavirus (COVID-19) poses a challenge to health promotion in the days of lockdown. We aimed to evaluate the characteristics of lifestyle in China during the initial stage of COVID-19 lock down. Methods: The questionnaire was distributed to Chinese adults living in 31 provinces of China via internet using a snowball sampling strategy. Information on 7-day physical activity recall, sedentary screen time, and emotional state were collected between January 24 and February 2, 2020. ANOVA, χ² test, and spearman’s correlation coefficient were used for statistical analysis. Findings: 12107 participants aged 18-80 years old were included. During the initial phase of 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 during home stay (261·3 ± 189·8 minutes per day). Of all participants, the positive affect score was 24·78 and the negative affect score was 19·34. In addition, we found that the proportions of confirmed COVID-9 cases were positively and significantly correlated with provincial negative affect scores (r=0·501, p =0·004) but not correlated with the prevalence of insufficient physical activity, screen time, and positive scores ( p >0·05). Individuals with vigorous physical activity appeared to have better emotional state and less sedentary screen time than those with light physical activity. Interpretation: During this nationwide lockdown, more than half of Chinese adults were temporarily living in a sedentary lifestyle with insufficient physical activity, more screen time, and poor emotion states, which may carry considerable health risks. Promotion of home-based self-exercise can potentially help improve health and wellness. Funding Statement: This study was funded by the National Key Technology R&D Program (2019YFF0301600), and the National Natural Science Foundation of China (31371195 and 11775059). Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: Full ethical approval was obtained from the China Institute of Sport Science, Beijing, China (CISS-2020-01-28). All participants gave their informed consent.