Abstract
This study aimed to explore the impact of COVID-19 on patients with eating spectrum disorders and the burden of resource utilization in the pre- and during COVID-19 pandemic. This retrospective observational study included patients diagnosed with anorexia, bulimia, and other eating disorders (OED) between 1st January 2018 to 31st December 2021 using ICD-10-CM codes from Optum’s de-identified Clinformatics Data Mart database. In this duration, distinct patients were identified and further classified by age, gender, and place of service. To determine the influence in pre- and during COVID-19 for each of the stratification variables, a year-wise comparison was done. Chi-square test of significance was performed for categorical variables. We observed the number of anorexia and bulimia cases among patients with eating spectrum disorders increased significantly during the pandemic (1st January 2020 – 31st December 2020) (p<.01). In the case of teenagers and adults, anorexia was found to have increased by 20% and 5%, respectively, while OED was found to have increased by 6% and 2%, respectively during pandemic. When stratified by gender, only anorexia (females [21%], men [10%] and OED (females [26%], males [18%] showed a substantial increase during the pandemic. Healthcare resources utilization: for inpatients, anorexia and OED increased significantly (10% and 3%), bulimia decreased significantly (5%); for office visits, anorexia increased significantly (3%), bulimia and OED decreased significantly (8% and 3%). Anorexia, bulimia, and OED showed a significant increase in outpatient visits (71%, 68%, 76% respectively); and in telehealth services (2,152%; 1,924%; and 1,727% respectively) (p<.01). An increased exacerbation in eating spectrum disorder was observed during the pandemic, especially in telehealth services. With the increase in cases, health care resource utilization across various settings is pressed. Better treatment and programs may be required to curb this impact and decrease the overall burden.
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