The variables studied by the WHOQoL-BREF questionnaire are related to people's health and well-being. The results of the present study suggest that the initial three month-period of social isolation imposed by the pandemic COVID-19 led to a significant reduction in the perception of quality of life and satisfaction with the health of the interviewed individuals.
All domains evaluated by WHOQoL-BREF showed a significant worsening in the three months of social isolation. This was expected, considering that many components of social life interfere in the quality of life of individuals and/or populations (15).
One of the components considered in the Physical domain is sleep and rest; it is known that changes in sleep interfere in people's quality of life generating stress (16). The Psychological Domain involves positive feelings, thinking, learning, memory and concentration, body image and appearance, negative feelings, spirituality/religion/ personal beliefs while the Domain of Social Relations, encompassing the perception of personal relationships, social support, and sexual activity. Such components of each domain were negatively impacted. We can hypothesize that social isolation led the population to change their usual routine and reduce physical and social contact with people, which can cause frustration and increasing stress leading to negative impacts on mental health, like what has being found by other researchers (17). When analyzing these results, one must consider that individuals from low socioeconomic status, such as our sample, are more vulnerable to poor physical, psychological, and emotional health and quality of life (18).
The Environment domain of quality of life considers the perception of physical security and protection, environment in the home, financial resources, health and social care, physical environment, transportation, among others. In this regard, it is important to state Pereira et al. (2012) that when assessing the quality of life in terms of the perception of people or groups, it is necessary to reflect on the relevant factors, considering socio-cultural, environmental, and social aspects. Our results show a worsening of the quality of life in all environmental characteristics, a result that was expected, since the fear of getting the virus and not being able to have the proper health care was established in Sao Paulo during that time, with a hospital full of contaminated patients. This result might also be related to the fact that individuals from low-income families are more prone to rely on the daily income that may not be available during the lockdown or to lose their jobs during times of crisis, which was also related to negative effects of the COVID-19 pandemic in the quality of life in a study conducted in Saudi Arabia (19). Moreover, we must consider that families might be confined in a small space, with very little personal space for each family member, which might lead to conflicts and a reduction in satisfaction with the quality of life.
Defining public policies and essential care components for populations victims of emergencies is fundamental, but there are no universal protocols or guidelines for the most effective psychosocial support practices (20). The results found in the present research and others conducted during the COVID-19 pandemic should be considered when designing strategies for maintaining the quality of life during times of crises, and when determining who should be prioritized in receiving care.