Physical Activity Levels and Mental Health Burden of Healthcare Workers during COVID-19 Lockdown Zaylea Kua1, Fadzil Hamzah2, Pei Ting Tan3, Li Jiuen Ong4, Benedict Tan2, Zhongwei Huang5,6,7* 1 Department of Psychological Medicine, Changi General Hospital, Singapore 2 Department of Sport & Exercise Medicine, Changi General Hospital, Singapore 3 Clinical Trials & Research Unit, Changi General Hospital, Singapore 4 Department of Dietetics, Changi General Hospital, Singapore 5 Department of Obstetrics & Gynaecology, National University Health Systems, Singapore 6 Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore 7 Institute of Molecular and Cell Biology, Agency of Science, Technology and Research, Singapore *Corresponding author: Dr. Zhongwei Huang; Associate Consultant & Research Clinician Departments of Physiology, Obstetrics & Gynaecology National University Health System Tower Block Level 12 1E Kent Ridge Road Singapore 119228 obgzwh@nus.edu.sg Acknowledgement: None. Declaration of Competing Interest: The authors declare that there are no conflicts of interest. The data that support the findings of this study are available from the corresponding author, [Z.H.], upon reasonable request. Abstract The outbreak of COVID-19 has precipitated international lockdown measures to curb disease transmissions. The closure of public activity spaces as well as changes in pandemic workload may disrupt healthcare workers’ physical activity levels and self-care routines. We sought to examine the association between physical activity levels and mental health burden of healthcare workers during the COVID-19 lockdown in Singapore. This cross-sectional survey was administered digitally to 707 healthcare workers between May 17 and June 18 2020. Exercise frequency, duration and intensity of these healthcare workers had reduced significantly during the lockdown compared to pre-lockdown. 42.7%, 37.2%, and 11.9% screened positive for moderate-to-extremely-severe depression, anxiety and stress respectively. Reductions in exercise duration was a significant risk factor for mild stress and moderate-tosevere depression while increase in exercise frequency was found to be a protective factor against depressed mood. Our study revealed that a short-term reduction in physical activity levels during lockdown was associated with poorer psychological outcomes. Given the protection that exercise confers on depression, physical activity should be promoted at the workplace and at home to support healthcare workers to cope through this protracted health crisis.