IMPORTANCE School closures as part of broader social lockdown measures during the COVID-19 pandemic may be associated with the health and well-being of children and adolescents. OBJECTIVE To review published reports on the association of school closures during broader social lockdown with mental health, health behaviors, and well-being in children and adolescents aged 0 to 19 years, excluding associations with transmission of infection. EVIDENCE REVIEW Eleven databases were searched from inception to September 2020, and machine learning was applied for screening articles. A total of 16 817 records were screened, 151 were reviewed in full text, and 36 studies were included. Quality assessment was tailored to study type. A narrative synthesis of results was undertaken because data did not allow meta-analysis. FINDINGS A total of 36 studies from 11 countries were identified, involving a total of 79 781 children and adolescents and 18 028 parents, which occurred during the first wave of the COVID-19 pandemic (February to July 2020). All evaluated school closure as part of broader social lockdown during the first COVID-19 wave, and the duration of school closure ranged from 1 week to 3 months. Of those, 9 (25%) were longitudinal pre-post studies, 5 (14%) were cohort, 21 (58%) were cross-sectional, and 1 (3%) was a modeling study. Thirteen studies (36%) were high quality, 17 (47%) were medium quality, and 6 (17%) were low quality. Twenty-three studies (64%) were published, 8 (22%) were online reports, and 5 (14%) were preprints. Twenty-five studies (69%) concerning mental health identified associations across emotional, behavioral, and restlessness/inattention problems; 18% to 60% of children and adolescents scored above risk thresholds for distress, particularly anxiety and depressive symptoms, and 2 studies reported no significant association with suicide. Three studies reported that child protection referrals were lower than expected number of referrals originating in schools. Three studies suggested higher screen time usage, 2 studies reported greater social media use, and 6 studies reported lower physical activity. Studies on sleep (10 studies) and diet (5 studies) provided inconclusive evidence on harms. CONCLUSIONS AND RELEVANCE In this narrative synthesis of reports from the first wave of the COVID-19 pandemic, studies of short-term school closures as part of social lockdown measures reported adverse mental health symptoms and health behaviors among children and adolescents. Associations between school closure and health outcomes and behaviors could not be separated from broader lockdown measures.

中文翻译：

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第一次 COVID-19 浪潮期间社会封锁期间的学校停课和儿童和青少年的心理健康、健康行为和福祉：系统评价。

重要性 在 COVID-19 大流行期间，作为更广泛的社会封锁措施的一部分，学校停课可能与儿童和青少年的健康和福祉有关。目的 回顾已发表的关于在更广泛的社会封锁期间停课与 0 至 19 岁儿童和青少年的心理健康、健康行为和福祉之间的关联的报告，不包括与感染传播的关联。证据审查从开始到 2020 年 9 月，共检索了 11 个数据库，并应用机器学习筛选文章。共筛选16 817条记录，全文回顾151条，纳入36项研究。质量评估是根据研究类型量身定制的。由于数据不允许进行荟萃分析，因此对结果进行了叙述性综合。结果 共确定了来自 11 个国家的 36 项研究，共涉及 79 781 名儿童和青少年以及 18 028 名父母，这些研究发生在第一波 COVID-19 大流行期间（2020 年 2 月至 7 月）。在第一次 COVID-19 浪潮期间，所有人都将学校停课评估为更广泛的社会封锁的一部分，学校停课的持续时间从 1 周到 3 个月不等。其中，9 项 (25%) 为纵向前后研究，5 项 (14%) 为队列研究，21 项 (58%) 为横断面研究，1 项 (3%) 为建模研究。13 项研究 (36%) 为高质量，17 项 (47%) 为中等质量，6 项 (17%) 为低质量。发表了 23 项研究 (64%)，8 项 (22%) 为在线报告，5 项 (14%) 为预印本。25 项关于心理健康的研究 (69%) 确定了情绪、行为、和烦躁/注意力不集中的问题；18% 至 60% 的儿童和青少年在痛苦，特别是焦虑和抑郁症状方面得分高于风险阈值，2 项研究报告与自杀没有显着相关性。三项研究报告称，来自学校的儿童保护转介人数低于预期的转介人数。三项研究表明屏幕时间使用率更高，2 项研究报告更多社交媒体使用，6 项研究报告身体活动减少。关于睡眠（10 项研究）和饮食（5 项研究）的研究提供了关于危害的不确定证据。结论和相关性 在这篇对第一波 COVID-19 大流行报告的叙述性综合中，作为社会封锁措施一部分的短期学校停课研究报告了儿童和青少年的不良心理健康症状和健康行为。学校停课与健康结果和行为之间的关联离不开更广泛的封锁措施。