Psychiatric comorbidities and dehydration are more common in children admitted to the emergency department for eating disorders in the COVID-19 era.

Giulia Spina,Marco Roversi,Valeria Zanna,Francesca Fini,Anna Clemente,Gianluca Mirra,Maria Chiara Castiglioni,Antonella Diamanti,Alberto Villani,Maria Rosaria Marchili,Antonino Reale,Benedetta Guarnieri,Umberto Raucci,Stefano Vicari,Giulia Testa

doi:10.1007/s40519-022-01386-7

Abstract

PurposeSince the beginning of COVID-19 pandemic, social distancing and home confinement had a significant impact on children, especially on those with eating disorders (ED). The primary objective of this retrospective study was to describe and analyze the demographic and clinical profiles of children presenting with ED during the COVID-19 pandemic.MethodsWe conducted a retrospective review of clinical charts of patients with ED younger than 18 years who accessed the emergency department of the Bambino Gesù Children’s Hospital, Rome, between March 2019 and March 2021. Of these, we reported and compared the demographic, clinical and laboratory data before and after the COVID-19 pandemic and looked for predictors of ED severity.ResultsA total of 211 admissions for ED were recorded. The patients, mostly females (86.3%) were on average 14.1 years old. The mean weight loss on admission was 11 kg. Bradycardia was observed in 31.3% of the study sample. 16.6% of patients had an associated psychiatric disorder and 60.2% required psychotropic drugs. 68.7% of the patients required hospitalization. Respectively, 96 and 115 patients were admitted before and during the COVID-19 pandemic. The latter were hospitalized more (78.3 vs 57.3%; p = 0.001), yet for less time (19 vs 26 days; p = 0.004), had a higher mean serum creatinine (0.68 vs 0.47; p < 0.001) and were more frequently diagnosed with an associated psychiatric disorder (23.5 vs 8.3%; p = 0.003).ConclusionOur study shows a significant increase of hospitalizations of children with ED during the COVID-19 pandemic, along with a shorter length of stay, more psychiatric comorbidities, and some distinctive features at the laboratory work-up, such as an increase of serum creatinine and/or a reduction of serum albumin.Level of evidenceIII, evidence obtained from well-designed cohort or case–control analytic studies.

Highlights

Since the onset of the COVID-19 pandemic, the introduction of never-before-experienced restrictions, such as social distancing and home confinement, has had a significant impact on children’s emotional and social spheres
Patients included were on average 14.1 (± 2.5) years old, mostly females (86.3%). 81% of patients came from the Lazio region. 68.7% of the patients were hospitalized, for a mean period of 22 (± 14) days
16.6% of patients were diagnosed with a psychiatric disorder other than eating disorders (ED), but 60.2% of the study sample required administration of psychotropic drugs, mostly aripiprazole (51.2%) and sertraline (25.6%)

Summary

Introduction

Since the onset of the COVID-19 pandemic, the introduction of never-before-experienced restrictions, such as social distancing and home confinement, has had a significant impact on children’s emotional and social spheres. COVID-19-related isolation has resulted in an increase in mental health conditions, such as post-traumatic stress disorder [6, 11], anxiety and depression [12, 13]. The social impact of confinement and isolation associated with lockdown has recently been described in the pediatric field. According to an estimate by the Italian Ministry of Education, University, and Research (MIUR), approximately 8.5 million students remained at home during the pandemic [14]. The combination of these stressors could both exacerbate pre-existing mental health problems and cause their onset, in children and adolescents [15]

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