1225 Paediatric eating disorder presentations to a district general hospital prior to, and during, the COVID-19 pandemic

Abstract

<h3>Background</h3> The COVID-19 pandemic rapidly spread worldwide during 2020, with the first UK case seen at the end of January. During the pandemic a global increase in the number of eating disorder presentations to acute paediatric departments has been noted.¹ Assessing the impact of this locally is essential for determining changes in policies, training and service provision to ensure the needs of these young people are met. <h3>Objectives</h3> This retrospective study compared the number, type and acuity of patients presenting with eating disorders to a single district general hospital in England, before and during the global COVID-19 pandemic. The potential impact of related national events, such as lockdowns and school closures, on these admissions was considered. <h3>Methods</h3> Information was collected on all patients aged &lt;18 years admitted to the ward with a primary diagnosis of eating disorder (falling under the ICD-10 classification F50) over a 26 month period, ‘pre-COVID’ (January 2019-January 2020) and ‘post-COVID’ (February 2020-February 2021). Data recorded included: monthly admission numbers, need for nasogastric tube (NGT) feeding or registered mental health nurse (RMN) support during admission, length of stay and discharge location. <h3>Results</h3> During the COVID pandemic (‘post-COVID’ period) there has been a significant increase in eating disorder admissions for acute nutritional support with a 283% increase in inpatient numbers (average 0.6 admissions/month pre-COVID vs 2.3 post-COVID). Despite the higher admission numbers, those admitted ‘post-COVID’ were less likely to: require NGT feeding (63% required NGT feeding in the pre-COVID period, compared with 33% in the post-COVID period) need RMN support (25% pre vs 10% post) be discharged to a tier 4 bed (50% in the pre-COVID period compared with 13% in the post-COVID period) However ‘post-COVID’ a proportion of young people required sectioning under the Mental Health Act (7% vs 0% pre) to enable assessment and treatment and the average length of stay was increased by over 50% (pre average 7.5 days vs post 11.3 days) (p=0.058). <h3>Conclusions</h3> Such significant increases in the number of eating disorder patients admitted to paediatric inpatient units will have a significant impact on acute services, even if the co-existent mental health acuity appears equivalent or lower than pre-pandemic. The look of inpatient paediatric wards may be forever changed and staff training, inpatient facilities and multidisciplinary services need to adapt accordingly. Post-pandemic changes will also need to be monitored to review how further service modifications may be necessary in the future. <h3>Reference</h3> Haripersad YV, Kannegiesser-Bailey M, Morton K, et al. Outbreak of anorexia nervosa admissions during the COVID-19 pandemic. Archives of Disease in Childhood 2021;106:e15.