ArticleFrontiers in pediatrics2026
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.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: 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 13-17 years). Methods: 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®); HRQoL (Pediatric Quality of Life Inventory™ [PedsQL™] Generic Core Scales); loneliness (Direct Measure of Loneliness [DMOL] scale); health-state utility (EQ-5D-5L); mental health (Hospital Anxiety and Depression Scale; HADS®); and school and activity impairment (Work Productivity and Activity Impairment plus Classroom Impairment Questions: Specific Health Problem questionnaire; WPAI-CIQ:SHP). Results: 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™ Generic Core Scales mean total score was 58.0 (scale range: 0-100, where higher scores indicate better HRQoL). Most outcomes moderately correlated with PDS-C19 (| Conclusions: 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.
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