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

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

doi:10.21203/rs.3.rs-1159494/v1

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…In some cohorts of AN patients, psychiatric comorbidities and dehydration were more common on hospital admission in the COVID-19 era, compared to previous years [4]; in other studies, disease characteristics were not more severe as compared to the preceding 5 years [3]. Considering that contextual variables that may influence AN onset in adolescents include (a) parents' level of acculturation, (b) family socioeconomic status (SES), (c) peer socialization, (d) family structure, and (e) immigration status [5][6][7][8], we hypothesized possible differences in prevalence of hospitalization and/or disease severity, related to SES and/or ethnicity, that, to the best of our knowledge, have not been studied during the COVID-19 era.…”

Section: Introductionmentioning

confidence: 98%

Disease Characteristics and Psychiatric Comorbidities in Adolescents with Anorexia Nervosa Hospitalized During COVID-19 Pandemic

Girardi¹,

Assalone²,

Maines³

et al. 2022

Front. Biosci. (Schol Ed)

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Background: Since the beginning of COVID-19 pandemic, an increase in new diagnoses and pediatric hospital admission for anorexia nervosa (AN) or atypical AN in adolescents have been reported, suggesting an adverse effect of COVID-19 on youth mental health. We hypothesized possible differences in prevalence of hospitalization and/or disease severity, related to socio-economic status and/or ethnicity. Methods: Retrospectively, patients were divided into two subgroups and compared according to the date of first hospital admission: "pre SARS-COV2 era" group (n. 45, 8th March 2016-8th March 2020) and "SARS-COV2 era" group (n. 43, 9th March 2020-8th March 2022). Results: During the two years of the SARS-COV2 era, we reported an increase in hospital admission incidence more than doubled respect to the "pre-SARS-COV2 era". The "SARS-COV2 era group" showed a more rapid weight loss (p = 0.005), a minor duration of weight loss from lifetime maximum to admission (p = 0.019) and needed most frequently treatments with intravenous fluids (p < 0.0001), oral dietetic supplements (p < 0.001) and enteral nutrition by nasogastric tube (p = 0.002). The same group presented higher prevalence of psychiatric comorbidities (63% vs. 22%, p < 0.0001) and required most frequently treatments with psychotropic drugs (56% vs. 24%, p = 0.002). We found higher family socioeconomic status (SES) in our patients with AN in both the periods and we did not find a shift in social class distribution over time. Conclusions: Our study confirms a significant increase in incidence of hospitalization and of psychiatric comorbidity in the pediatric population with AN during the second year of COVID-19 pandemic, regardless of SES or ethnic background. Further studies are needed to understand potential mechanisms that during COVID-19 pandemic trigger eating disorder symptoms.

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Section: Introductionmentioning

confidence: 98%

Disease Characteristics and Psychiatric Comorbidities in Adolescents with Anorexia Nervosa Hospitalized During COVID-19 Pandemic

Girardi¹,

Assalone²,

Maines³

et al. 2022

Front. Biosci. (Schol Ed)

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“…Well documented research has proven that patients with eating disorders, especially with anorexia nervosa, are at risk of many somatic and psychiatric comorbidities and higher mortality (15,(27)(28)(29)(30). Our study results show a positive correlation between restrictive eating behavior and symptoms of depression.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the COVID pandemic has caused an increase in mental stress in children, adolescents, and their families worldwide. A rise in depression and anxiety disorders has been reported, as reflected by increased admissions due to severe eating disorders and suicide attempts (5,(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

“…It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and can affect any system in the body. (7) -Low body weight not better accounted for by another medical condition or the unavailability of food -Persistent pattern of restrictive eating or other behavior aimed at establishing or maintaining abnormally low body weight, typically associated with extreme fear of weight gain -Excessive preoccupation with body weight or image(15)…”

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confidence: 99%

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Development of restrictive eating disorders in children and adolescents with long-COVID-associated smell and taste dysfunction

et al. 2022

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BackgroundAbsent or abnormal senses of smell and taste have been frequently reported during both acute and long COVID in adult patients. In contrast, pediatric patients who test positive for SARS-CoV-2 are often asymptomatic and the loss of smell and/or taste has been infrequently reported. After observing several young patients with COVID-associated anosmia and ageusia at our clinic, we decided to investigate the incidence of subsequent eating disorders in these patients and in SARS-CoV-2 positive patients who did not experience anosmia and ageusia during the same period.Material and methodsA single-site retrospective cohort study of 84 pediatric patients with suspected long COVID who were treated in the Pediatric Infectious Diseases Outpatient Clinic at the University Hospital Essen were evaluated for persistent symptoms of COVID-19. Smell and taste dysfunction as well as eating behaviors were among the signs and symptoms analyzed in this study.Results24 out of 84 children and adolescents described smell and taste dysfunction after confirmed or suspected SARS-CoV-2 infections. A large number of these patients (6 out of 24) demonstrated increased fixation on their eating behavior post-COVID and over time these patients developed anorexia nervosa.Discussion/ConclusionIn this study we saw a possible association of long-lasting post-COVID smell and taste dysfunction with subsequent development of eating disorders. This observation is worrisome and merits further investigation by healthcare providers at multiple clinical sites.

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COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses

2023

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Purpose The COVID-19 pandemic has been a leading cause of stress and feelings of loss of control, both of which have been related to eating disorder (ED) pathology onset and deterioration. We aim to estimate the magnitude of changes in the prevalence rates of, and indicators for, ED psychopathology in the face of the COVID-19 pandemic. Method Pre-registered systematic review with frequentist and Bayesian meta-analyses. Searches for eligible studies were performed in PubMed, Web of Science and pre-print servers until January 15 2023. Results Our searches yielded 46 eligible studies reporting on a total of 4,688,559 subjects. These data provide strong evidence indicating increased rates of diagnosed and self-reported ED’s and a concordant increased need for care in the face of the pandemic. ED symptom severity scores in patients were not elevated during the pandemic, except for those related to anorexia nervosa. On average, people in the general population report relatively high levels of emotional and binge eating during the pandemic, although the evidential strength for these associations is only anecdotal to moderate. Moderators of between-study heterogeneity were not detected. Conclusions Altogether, our results suggest that the COVID-19 pandemic is associated with a wide spread negative effect on ED pathology in patient samples and the general population. The development of online prevention and intervention programs for EDs during stressful times like a pandemic is encouraged. A limitation is that the results reported here may be prone to biases, amongst others, self-report bias. Level of evidence: Level I, systematic review and meta-analysis. Preregistration: Prospero [https://www.crd.york.ac.uk/prospero] ID: CRD42022316105.

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

Cited by 3 publications

References 20 publications

Disease Characteristics and Psychiatric Comorbidities in Adolescents with Anorexia Nervosa Hospitalized During COVID-19 Pandemic

Disease Characteristics and Psychiatric Comorbidities in Adolescents with Anorexia Nervosa Hospitalized During COVID-19 Pandemic

Development of restrictive eating disorders in children and adolescents with long-COVID-associated smell and taste dysfunction

COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses

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