{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:27Z","timestamp":1779951747382,"version":"3.53.1"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We describe physical distancing behaviors to avoid coronavirus disease 2019 (COVID-19) and their associations with health-related quality of life (HRQoL) and related outcomes, among immunocompromised adolescents (aged 13\u201317 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>EAGLE was a cross-sectional, observational study of immunocompromised adults, adolescents, and children in the United States and United Kingdom. Adolescents and their caregivers were enrolled between February and June 2023 and completed a web-based survey that was designed to capture the following outcomes: physical distancing behaviors in the past 4 weeks, measured using the Physical Distancing Scale for COVID-19 Avoidance (PDS-C19\u00ae); HRQoL (Pediatric Quality of Life Inventory\u2122 [PedsQL\u2122] Generic Core Scales); loneliness (Direct Measure of Loneliness [DMOL] scale); health-state utility (EQ-5D-5L); mental health (Hospital Anxiety and Depression Scale; HADS\u00ae); and school and activity impairment (Work Productivity and Activity Impairment plus Classroom Impairment Questions: Specific Health Problem questionnaire; WPAI-CIQ:SHP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 405 immunocompromised adolescents, the PDS-C19 mean T-score was 49.1, indicative of moderate physical distancing intensity. Most participants reported moderate (60.1%) or high\/very high (16.3%) physical distancing intensity; fewer reported low (10.0%) or very low (13.7%) physical distancing intensity. The PedsQL\u2122 Generic Core Scales mean total score was 58.0 (scale range: 0\u2013100, where higher scores indicate better HRQoL). Most outcomes moderately correlated with PDS-C19 (|\n                      <jats:italic>r<\/jats:italic>\n                      |\u2009=\u20090.4\u20130.5), with stronger correlations (|\n                      <jats:italic>r<\/jats:italic>\n                      |&amp;gt;0.6) shown for WPAI-CIQ:SHP activity impairment, school presenteeism, and overall school impairment. Linear regression models adjusting for confounders showed similar associations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Two years after national lockdowns ended, most immunocompromised adolescents practiced moderate-to-high intensities of physical distancing to avoid COVID-19. Higher intensities of physical distancing were associated with worse HRQoL and greater school and activity impairment, emphasizing the prolonged burden of COVID-19 avoidance in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1771834","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:16:05Z","timestamp":1779948965000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the association of physical distancing to avoid COVID-19 with health-related quality of life in immunocompromised adolescents: results from the cross-sectional observational EAGLE study"],"prefix":"10.3389","volume":"14","author":[{"given":"Paul","family":"Williams","sequence":"first","affiliation":[{"name":"Medical Evidence, BioPharmaceuticals Medical, AstraZeneca","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy A.","family":"Herring","sequence":"additional","affiliation":[{"name":"Medical Evidence, Vaccines & Immune Therapies, BioPharmaceuticals Medical, AstraZeneca","place":["Wilmington, DE, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata T. 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