{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:59:14Z","timestamp":1782842354350,"version":"3.54.5"},"reference-count":11,"publisher":"JMIR Publications Inc.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020, and as of this writing, Texas, United States, has reported >675,000 cases with over 14,000 deaths. Many of the preventive measures implemented during the pandemic can increase sedentary lifestyles, which can lead to the development of chronic diseases, including obesity, among the general population and cause serious threats to people\u2019s physical health and overall quality of life. Individuals with pre-existing comorbidities are at an increased risk of COVID-19 and may hence have higher levels of stress.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate the relationship between physical activity levels and mental health status on an individual level and to compare them between those with and those without comorbidities in a cohort of Texas residents, before and after COVID-19 was declared a pandemic.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n An electronic survey was disseminated throughout various regions of Texas. In total, 160 individuals were asked questions about their demographic characteristics, time spent on daily physical activities, and daily mental health status before and after COVID-19 was declared a pandemic. Frequency distributions and descriptive statistics were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall, 94 (58%) participants reported having \u22651 medical condition, and 31 (13.1%) had >3 medical conditions. Physical activity levels among participants with \u22651 pre-existing comorbidity drastically\u2014but not significantly\u2014decreased, as evident from a 10% increase in sedentary lifestyles after COVID-19 was declared a pandemic. On the contrary, we observed a 9% increase in the number of individuals without a pre-existing comorbidity who reported 30-60 min of physical activity per week. There was a 2-fold increase in the number of participants reporting more frequent feelings of nervousness, too much worry, trouble relaxing, and the fear of something awful happening after the pandemic. More specifically, individuals with pre-existing medical conditions reported, on average, a 10% higher incidence of feelings of stress, anxiety, and sadness compared to their healthy counterparts after COVID-19 was declared a pandemic.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Stressful life conditions and chronic comorbidities are risk factors that can affect mental health and reduce the ability to perform activities of daily life. Therefore, when implementing pandemic protocols, municipalities should consider providing mental health support to their citizens to protect them from this rather inconspicuous adverse effect.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/24964","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T06:52:33Z","timestamp":1616050353000},"page":"e24964","source":"Crossref","is-referenced-by-count":7,"title":["Decline of Psychological Health Following the Designation of COVID-19 as a Pandemic: Descriptive Study"],"prefix":"10.2196","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8124-8072","authenticated-orcid":false,"given":"Darpan I","family":"Patel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2103-8599","authenticated-orcid":false,"given":"Yazmin","family":"Gamez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0276-8251","authenticated-orcid":false,"given":"Lajja","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3784-3688","authenticated-orcid":false,"given":"Jaini","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2021,4,22]]},"reference":[{"key":"ref1","unstructured":"WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020World Health Organization202003112021-04-05https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.7326\/M20-2665"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3390\/nu12061583"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.31234\/osf.io\/uacfj"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2020.1757052"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23066"},{"key":"ref7","unstructured":"How REDCap is being used in response to COVID-19REDCap2021-04-06https:\/\/www.project-redcap.org\/"},{"issue":"1","key":"ref8","first-page":"A14","volume":"2","author":"Chapman, D","year":"2005","journal-title":"Prev Chronic Dis"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032013-182435"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.2147\/OARRR.S269889"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318213fefb"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2021\/4\/e24964","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:36:23Z","timestamp":1782840983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2021\/4\/e24964"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,22]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.2196\/24964","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.24964","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,22]]}}}