Objective: this study investigated the impact of the 2019 coronavirus disease pandemic (COVID-19) on health-related quality of life (HRQoL) and psychological status among adults living in Saudi adults, and whether physical activity modifies this association. Methods: This study was a cross-sectional study. Data collected using an online survey, data including demographic information, the impact of COVID-19 (assessed by the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5), HRQoL (Short Form-8), psychological distress (Depression, Anxiety and Stress Scale), and physical activity behavior (International Physical Activity Questionnaire-Short Form) were collected. Results: 518 adults aged ≥18 years (67.4% men) have participated in this study. Adults reporting moderate or high impact of COVID-19 had a lower HRQoL and higher psychological distress than adults reporting a low impact. HRQoL was higher for adults reporting any level impact (low, moderate, or high) of COVID-19 when they participated in recommended levels of physical activity (≥600 metabolic equivalent (MET)-min/week of total physical activity). Moreover, psychological distress was lower in adults reporting a high impact of COVID-19 when they participated in recommended physical activity. Conclusion: In people who have reported a moderate to high impact of COVID-19, this impact was associated with a significantly lower HRQoL and higher psychological distress when compared to those who have reported a low impact level of COVID-19 on them. However, these associations were moderated by the recommended levels of physical activity. Therefore, future studies should consider a longitudinal study design to establish a cause and-effect relationship between the impact of COVID-19 on adults and their HRQoL, psychological status, and level of physical activity.
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