BACKGROUND: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. METHODS: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www.coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via non-probability/snowball and representative sampling and assessed via self-rating and parental rating. Non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co-primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. RESULTS: Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COH-FIT project, with representative samples from eleven countries. LIMITATIONS: Cross-sectional and anonymous design. CONCLUSIONS: Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on children's, adolescents' and families', mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.

Academisch Medisch Centrum Universiteit van Amsterdam Amsterdam The Netherlands

Adnan Menderes University Department of Child and Adolescent Psychiatry Aydın Turkey

An Nan Hospital China Medical University Department of Psychiatry Tainan Taiwan; Maastricht University Department of Psychiatry and Neuropsychology Maastricht The Netherlands

Aristotle University of Thessaloniki 2 Dept of Psychiatry Division of Neurosciences Medical School Faculty of Health Sciences Greece

ASL Salerno Department of Mental Health Salerno Italy

Asociación Psiquiátrica Mexicana Mexico

Association for the Improvement of Mental Health Programmes Switzerland

AULSS4 Veneto Orientale Addictions Department Italy

Belarusian Medical Academy of Postgraduate Education Belarus

BioPsyC Biopsychosocial Corporation Non profit association for Research Funding Ltd Vienna Austria

Boehringer Ingelheim USA

Centre for Addiction and Mental Health Canada

Chairman Pakistan Psychiatric Research Centre Fountain House Lahore Pakistan

Charité Universitätsmedizin Berlin Department of Child and Adolescent Psychiatry Berlin Germany

Charité Universitätsmedizin Berlin Department of Child and Adolescent Psychiatry Berlin Germany; The Zucker Hillside Hospital Northwell Health New York USA; Donald and Barbara Zucker School of Medicine at Hofstra Northwell New York USA

China Medical University Beigang Hospital Division of Psychiatry Department of Internal Medicine Taiwan

China Medical University Hospital Mind Body Interface Research Center Taichung Taiwan; Department of Psychiatry and Behavioral Medicine Carilion Clinic Virginia Tech Carilion School of Medicine Roanoke VA USA

Chulalongkorn University Department of Psychiatry Thailand

Clienia AG Wetzikon Psychiatric Centre Switzerland

Deakin University School of Medicine Victoria Australia

Dean Faculty of Psychiatry College of Physicians and Surgeons Pakistan; Dean Jinnah Postgraduate Medical Centre Karachi Pakistan; Dean Faculty of Medicine Jinnah Sindh Medical University Karachi Pakistan

Early Psychosis Interventions and Clinical detection CIBERSAM Barcelona Spain; Karolinska Institutet Centre for Psychiatric Research and Education Department of Clinical Neuroscience Stockholm Sweden

Early Psychosis Interventions and Clinical detection Lab Department of Psychosis Studies Institute of Psychiatry Psychology and Neuroscience King's College London London United Kingdom; OASIS service South London and Maudsley NHS Foundation Trust London United Kingdom; University of Pavia Department of Brain and Behavioral Sciences Pavia Italy

Early Psychosis Interventions and Clinical detection Lab Department of Psychosis Studies Institute of Psychiatry Psychology and Neuroscience King's College London London United Kingdom; Universidad Católica Department of Psychology Montevideo Uruguay

Emergency Hospital Nicolae Oblu Iasi Romania

Eotvos Lorand University Institute of Psychology Budapest Hungary; Bjørknes University College Oslo Norway

Faculdade de Medicina da Universidade de São Paulo Departments of Internal Medicine and Psychiatry São Paulo Brazil

Federal Neuropsychiatric Hospital Department of Clinical Services Benin City Nigeria

FHNW University of Applied Sciences and Arts Northwestern Switzerland Switzerland

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Department of Neurosciences and Mental Health Milan Italy

Gaza Community Mental Health Programme Palestine

Griffith University South East Queensland Australia

Hannover Medical School Department of Psychiatry Social Psychiatry and Psychotherapy Germany

Heidelberg University Central Institute of Mental Health Medical Faculty Mannheim Germany

Hospital General Universitario Gregorio Marañón Department of Child and Adolescent Psychiatry Institute of Psychiatry and Mental Health IiSGM CIBERSAM Madrid Spain

Institut d'Investigacions Biomèdiques August Pi i Sunyer CIBERSAM Barcelona Spain

Institute de Psychiatrie et Neuroscience de Paris INSERM U1266 F 75014 Paris France; Université de Paris PEPIT GHU Paris Psychiatrie et Neuroscience Paris France

Institute de Recherché de Servier France

Institute of Psychiatry Socola Iasi Romania

Integrated Psychiatry Winterthur Switzerland

Integrated University Hospital of Verona Child and Adolescent Neuropsychiatry Unit Maternal Child Integrated Care Department Verona Italy

Irrua Specialist Teaching Hospital Department of Psychiatry Edo State Nigeria

Istanbul Basaksehir Cam ve Sakura City Hospital Department of Psychiatry Istanbul Turkey

Jubilee Mission Medical College and Research Institute Thrissur India

Karolinska Institutet Centre for Psychiatric Research and Education Department of Clinical Neuroscience Stockholm Sweden

Katholieke Universiteit Leuven Department of Neurosciences Leuven Belgium

Katholieke Universiteit Leuven Department of Rehabilitation Sciences Leuven Belgium

Keio University School of Medicine Department of Neuropsychiatry Tokyo Japan

Kermanshah University of Medical Sciences Medical Biology Research Center Kermanshah Iran

Kharazmi University Department of Clinical Psychology Faculty of Psychology and Education Tehran Iran

Kharazmi University Tehran Iran

King's College London Institute of Psychiatry Psychology and Neuroscience London United Kingdom

King's College London London United Kingdom

Kyambogo University Department of Sociology and Social Administration Kampala Uganda

Linköping University Pain and Rehabilitation Centre and Department of Health Medicine and Caring Sciences Linköping Sweden

Linköping University Pain and Rehabilitation Centre and Department of Health Medicine and Caring Sciences Linköping Sweden; University of Ioannina Research Laboratory Psychology of Patients Families and Health Professionals Department of Nursing School of Health Sciences Ioannina Greece

Lisbon's Psychiatric Hospital Centre Department of Psychiatry Portugal

Ludwig Maximilians University of Munich Munich Germany

Maastricht University Department of Psychiatry and Neuropsychology Maastricht The Netherlands

Medical University of Białystok Department of Infectious Diseases and Neuroinfections Poland

Medical University of Białystok Department of Population Medicine and Lifestyle Diseases Prevention Bialystok Poland

Mindgardens Neuroscience Network Sydney Australia

Moscow Research Institute of Psychiatry Moscow Russia

National Institute of Mental Health Klecany Czech Republic

National Institute of Public Health University of Southern Denmark Denmark

Okasha Institute of Psychiatry Faculty of Medicine Ain Shams University Cairo Egyp

Oran 1 University Department of Psychiatry Addictology Oran Algeria

Parc Sanitari Sant Joan de Deu Research and Development Unit CIBERSAM ICREA Barcelona Spain

Peking University Institute of Mental Health Department of Public Mental Health Pekin China

Pomeranian Medical University in Szczecin Department of Biochemical Sciences Szczecin Poland

Pomeranian Medical University in Szczecin Department of Biochemical Sciences Szczecin Poland; Sanprobi Sp z o o Sp k Poland

Pomeranian Medical University in Szczecin Department of Gastroenterology Szczecin Poland; The Centre for Digestive Diseases Endoklinika Szczecin Poland

Pomeranian Medical University in Szczecin Department of Psychiatry Szczecin Poland

Pontificia Universidad Católica de Chile Department of Psychiatry School of Medicine Santiago Chile

Psychiatric Services Grisons Department of Adult Psychiatry Switzerland

Psychiatry Department University of Medicine and Pharmacy Carol Davila Bucharest Prof Dr Alexandru Obregia Psychiatric Hospital Bucharest Romania

Psykiatrifonden Copenhagen Denmark

Pusan National University Yangsan Hospital Department of Psychiatry Yangsan Republic of Korea

Pushpagiri Institute of Medical Sciences Deptartment of Psychiatry Thiruvalla Kerala India

Republican Scientific and Practical Center of Mental Health Kazakhstan

Semmelweis University Department of Psychiatry and Psychotherapy Budapest Hungary

Seoul National University College of Medicine Department of Psychiatry Seoul Republic of Korea

Seoul National University Hospital Department of Neuropsychiatry Seoul Republic of Korea

Service de Psychiatrie de l'enfant et de l'adolescent GHNE 91440 Bures Sur Yvette France

Sheba Medical Center Israel

Shenzhen University School of Psychology Shenzhen China

Stanford University Department of Psychology California USA; Universitäre Psychiatrische Kliniken Basel Basel Switzerland

Stellenbosch University Department of Psychiatry Faculty of Medicine and Health Sciences South Africa

Technische Universität Dresden University Hospital Carl Gustav Carus Department of Psychiatry and Psychotherapy Dresden Germany

The National Foundation of Mental Health of Bangladesh Bangladesh

The Zucker Hillside Hospital Northwell Health New York USA; Donald and Barbara Zucker School of Medicine at Hofstra Northwell New York USA; Universitat Autònoma de Barcelona Centro de Investigación Biomédica en Red de Salud Mental Departament de Psiquiatria Barcelona Spain

The Zucker Hillside Hospital Northwell Health New York USA; Feinstein Institutes for Medical Research New York USA

Transilvania University of Brasov Faculty of Medicine Brasov Romania

UCLouvain Institute of Neuroscience and Cliniques Universitaires Saint Luc Department of Adult Psychiatry Brussels Belgium

Universidad Católica Department of Psychology Montevideo Uruguay

Universidade do Extremo Sul Catarinense Translational Psychiatry Laboratory Graduate Program in Health Sciences Criciúma SC Brazil

Universidade Federal de Santa Maria Department of Sports Methods and Techniques Santa Maria RS Brazil

Universidade Federal de São Paulo Department of Psychiatry São Paulo Brazil

Universitäre Psychiatrische Kliniken Basel Basel Switzerland; University of Basel Department of Sport Exercise and Health Division of Sport Science and Psychosocial Health Basel Switzerland; Kermanshah University of Medical Sciences Substance Abuse Prevention Research Center Kermanshah Iran; Kermanshah University of Medical Sciences Sleep Disorders Research Center Kermanshah Iran; Tehran University of Medical Sciences School of Medicine Tehran Iran

Université Clermont Auvergne CHU Clermont Ferrand Service de Psychiatrie B Clermont Ferrand France

Université de Paris CMME GHU Paris Psychiatrie et Neurosciences Paris France

Université de Paris CMME GHU Paris Psychiatrie et Neurosciences Paris France; Institute de Psychiatrie et Neuroscience de Paris INSERM U1266 F 75014 Paris France

University Hospital Zurich Department of Consultation Liaison Psychiatry and Psychosomatic Medicine Switzerland

University Medical Center Groningen University of Groningen Cognitive Neurosciences Department of Biomedical Sciences of Cells and Systems Groningen The Netherlands; University Medical Center Groningen University of Groningen Department of Psychiatry Groningen The Netherlands

University of Antioquia Department of Psychiatry Medellín Colombia

University of Barcelona Hospital Clínic Bipolar and Depressive Disorders Unit Institute of Neuroscience IDIBAPS CIBERSAM Barcelona Spain

University of Barcelona Hospital Clínic IDIBAPS CIBERSAM Barcelona Spain

University of Basel Universitäre Psychiatrische Kliniken Basel Basel Switzerland

University of Białystok Institute of Sociology Society and Cognition Unit Białystok Poland

University of Bristol Bristol United Kingdom

University of British Columbia Vancouver Canada

University of Calgary Alberta Health Services Calgary Canada

University of Cologne Cologne Germany

University of Copenhagen Copenhagen Denmark

University of Freiburg Department of Psychiatry and Psychotherapy Medical Center University of Freiburg Faculty of Medicine Freiburg Germany

University of Fribourg Fribourg Network of Mental Health Fribourg Switzerland

University of Greenwich School of Human Sciences London United Kingdom

University of Ioannina Department of Primary Education Ioannina Greece

University of Kragujevac Department of Psychiatry Faculty of Medical Sciences Kragujevac Serbia

University of Lausanne Department of Psychiatry Lausanne Switzerland

University of Lübeck Lübeck Germany

University of Manchester Division of Psychology and Mental Health Manchester United Kingdom

University of Medicine and Pharmacy Grigore T Popa Faculty of Medicine Iasi Romania

University of Milan Department of Pathophysiology and Transplantation Milan Italy

University of Milan Department of Pathophysiology and Transplantation Milan Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Department of Neurosciences and Mental Health Milan Italy

University of Minho Life and Health Sciences Research Institute School of Medicine Braga Portugal; ICVS 3B's PT Government Associate Laboratory Braga Guimarães Portugal

University of Modena and Reggio Emilia Clinical and Experimental Medicine PhD Program Modena Italy

University of Modena and Reggio Emilia Department of Biomedical Metabolic and Neural Sciences Modena Italy

University of Monastir Research Unit Vulnerability to Mental Disorders LR05ES10 Monastir Tunisia

University of Monastir University Hospital of Monastir Department of Psychiatry Monastir Tunisia

University of Natural Resources and Life Sciences Wien Austria

University of Nicosia Department of Life and Health Sciences Nicosia Cyprus

University of Ottawa Department of Psychiatry Ontario Canada

University of Ottawa Department of Psychiatry Ontario Canada; The Ottawa Hospital Department of Mental Health Ontario Canada; University of Ottawa Ottawa Hospital Research Institute Lab Department of Psychosis Studies Institute of Psychiatry Psychology and Neuroscience King's College London London United Kingdom; Centre for Innovation in Mental Health Developmental Lab School of Psychology University of Southampton and NHS Trust Southampton United Kingdom

University of Padova Padova Italy

University of Padua Neurosciences Department Padua Italy

University of Palermo Department of Internal Medicine Geriatrics Section Palermo Italy

University of Pavia Department of Brain and Behavioral Sciences Pavia Italy

University of Southampton Centre for Innovation in Mental Health Southampton United Kingdom

University of Southampton Centre for Innovation in Mental Health Southampton United Kingdom; University of Navarra Mind Brain Group Institute for Culture and Society Pamplona Spain

University of Texas Health Science Center Houston McGovern Medical School Louis A Faillace MD Department of Psychiatry and Behavioral Sciences USA

University of Toronto Toronto Canada

University of Verona Section of Psychiatry Department of Neurosciences Biomedicine and Movement Sciences Verona Italy

UNSW Sydney School of Psychiatry Sydney Australia

Uskudar University Department of Psychiatry and Psychology Istanbul Turkey

Utrecht University Medical Centre Department of Psychiatry Utrecht The Netherlands

Waterford Institute of Technology School of Health Sciences Waterford Ireland

Yonsei University College of Medicine Department of Pediatrics Seoul South Korea

Yonsei University Wonju College of Medicine Department of Psychiatry Wonju South Korea

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Validation of the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) questionnaire for adults

The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults): Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic