Medical Admissions Among Adolescents With Eating Disorders During the COVID-19 Pandemic

Otto, Alana K.; Jary, Jessica M.; Sturza, Julie; Miller, Catherine; Prohaska, Natalie; Bravender, Terrill; Huysse, Jessica Van

doi:10.1542/peds.2021-052201

Cited by 111 publications

(134 citation statements)

References 30 publications

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“…Our study con rms the onset of an "epidemic within the pandemic" [31], characterized by an increased severity of ED during the COVID-19 era, which is congruous with other reports [25,26]. As depicted in Figure 2, the epidemiological trend of ED admissions during the COVID-19 pandemic shows an overall increase compared to the previous pre COVID-19 year, with peaks and troughs of incidence that may be linked to emergency measures adopted by the Italian government such as school closures (the rst of which was announced on February 23rd, 2020) and their consequences: distance learning, home con nement, lifestyle changes [32].…”

Section: Discussionsupporting

confidence: 60%

Psychiatric Comorbidities and Dehydration are More Common in Children Admitted to the Emergency Department for Eating Disorders in the COVID-19 Era.

Spina

Roversi

Marchili

et al. 2022

Preprint

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Purpose Since 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.Methods We 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.Results A 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 associate 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).Conclusion Our 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 workup, such as an increase of serum creatinine and/or a reduction of serum albumin.Level of evidence III, evidence obtained from well-designed cohort or case-control analytic studies

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Section: Discussionsupporting

confidence: 60%

Psychiatric Comorbidities and Dehydration are More Common in Children Admitted to the Emergency Department for Eating Disorders in the COVID-19 Era.

Spina

Roversi

Marchili

et al. 2022

Preprint

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“…Following declines in weekly visits associated with MHCs among children and adolescents aged 0-17 years, during 2020 compared with 2019, weekly ED visits for MHCs overall and for specific MHCs varied by age and sex during 2021 and in January 2022. The current trends in the number and proportion of MHC-related ED visits, along with previous research (1,2,(4)(5)(6)(7)(8), indicate that the mental health effects of the pandemic might be particularly high among adolescent girls.…”

Section: Discussionmentioning

confidence: 80%

“…Increases in weekly visits for eating and tic disorders for females, and particularly among adolescent females aged 12-17 years during 2020, 2021, and in January 2022, could represent an overall increase in distress among females during the pandemic. Both eating and tic disorders can co-occur with anxiety, depression, and OCD (1,(4)(5)(6)(7). Eating disorders can be triggered by pandemic-related risk factors (e.g., lack of structure in daily routine, emotional distress, and changes in food availability) or exacerbated by reduced access to mental health care during the pandemic (4,5).…”

Section: Discussionmentioning

confidence: 99%

Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022

Radhakrishnan¹,

Leeb²,

Bitsko³

et al. 2022

MMWR Morb. Mortal. Wkly. Rep.

115

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On February 18, 2022, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr).In 2021, a national emergency* for children's mental health was declared by several pediatric health organizations, and the U.S. Surgeon General released an advisory † on mental health among youths. These actions resulted from ongoing concerns about children's mental health in the United States, which was exacerbated by the COVID-19 pandemic (1,2). During March-October 2020, among all emergency department (ED) visits, the proportion of mental health-related visits increased by 24% among U.S. children aged 5-11 years and 31% among adolescents aged 12-17 years, compared with 2019 (2). CDC examined changes in U.S. pediatric ED visits for overall mental health conditions (MHCs) and ED visits associated with specific MHCs (depression; anxiety; disruptive behavioral and impulse-control disorders; attention-deficit/hyperactivity disorder; trauma and stressor-related disorders; bipolar disorders; eating disorders; tic disorders; and obsessive-compulsive disorders [OCD]) during 2019 through January 2022 among children and adolescents aged 0-17 years, overall and by sex and age. After declines in weekly visits associated with MHCs among those aged 0-17 years during 2020, weekly numbers of ED visits for MHCs overall and for specific MHCs varied by age and sex during 2021 and January 2022, when compared with corresponding weeks in 2019. Among adolescent females aged 12-17 years, weekly visits increased for two of nine MHCs during 2020 (eating disorders and tic disorders), for four of nine MHCs during 2021 (depression, eating disorders, tic disorders, and OCD), and for five of nine MHCs during January 2022 (anxiety, trauma and stressor-related disorders, eating disorders, tic disorders, and OCD), and overall MHC visits during January 2022, compared with 2019. Early identification and expanded evidence-based prevention and intervention strategies are critical to improving children's and adolescents' * https://www.aap.org/en/advocacy/child-and-adolescent-healthy-mentaldevelopment/aap-aacap-cha-declaration-of-a-national-emergency-inchild-and-adolescent-mental-health/ † https://www.hhs.gov/sites/default/files/surgeon-general-youth-mental-healthadvisory.pdf

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“… 12 , 13 Similarly, a recent single-center study in the US reported a doubling of hospitalizations for restrictive eating disorders during the COVID-19 pandemic. 14 To date, the association between the pandemic and its confinement measures and the genesis of new-onset anorexia nervosa or atypical anorexia nervosa has not been studied. In this study, we sought to assess the incidence and severity of newly diagnosed anorexia nervosa or atypical anorexia nervosa in a national sample of children and adolescents before and during the first wave of the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Trends in the Incidence of New-Onset Anorexia Nervosa and Atypical Anorexia Nervosa Among Youth During the COVID-19 Pandemic in Canada

et al. 2021

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Medical Admissions Among Adolescents With Eating Disorders During the COVID-19 Pandemic

Cited by 111 publications

References 30 publications

Psychiatric Comorbidities and Dehydration are More Common in Children Admitted to the Emergency Department for Eating Disorders in the COVID-19 Era.

Psychiatric Comorbidities and Dehydration are More Common in Children Admitted to the Emergency Department for Eating Disorders in the COVID-19 Era.

Pediatric Emergency Department Visits Associated with Mental Health Conditions Before and During the COVID-19 Pandemic — United States, January 2019–January 2022

Trends in the Incidence of New-Onset Anorexia Nervosa and Atypical Anorexia Nervosa Among Youth During the COVID-19 Pandemic in Canada

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