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Martinelli M, Strisciuglio C, Lu P, Lev MRB, Beinvogl B, Di Lorenzo C, Cenni S, Nurko S, Pearlstein H, Rosen R, Shamir R, Staiano A. Impact of Coronavirus disease 2019 pandemic in children with functional abdominal pain disorders: Data from long-term follow-up. J Pediatr Gastroenterol Nutr 2024; 79:26-34. [PMID: 38698661 DOI: 10.1002/jpn3.12225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/20/2024] [Accepted: 03/22/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE We aimed to compare symptom frequency and severity in children with functional abdominal pain disorders (FAPDs) and to evaluate anxiety, quality of life (QoL) and global health during Coronavirus disease 2019 (COVID-19) related quarantine and after 17 months. METHODS Children diagnosed with FAPDs between October 2019 and February 2020 at 5 different centers were enrolled and prospectively interviewed during the COVID-19 quarantine and 17 months later when schools, hospital services, and routine activities had re-opened to the public. The patients were asked to complete the Rome IV questionnaire, the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) Generic Core Scale, the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and global health questionnaires. Data about COVID-19 infection and its clinical outcome were also collected. RESULTS Ninety-nine out of 180 (55%) children completed the follow-up. The number of patients reporting a worsening of their symptoms was significantly higher at follow-up when compared to the quarantine period (24/99 [24.2%] vs. 12/99 [12.1%]; p = 0.04). The PedsQL 4.0 subtotal score at follow-up significantly decreased at 17 months of follow-up (65.57 [0-100]) when compared to the quarantine (71 [0-100], p = 0.03). Emotional functioning was the most significantly reduced (Follow-up: 64.7 [0-100] vs. Quarantine: 75 [0-100]; p = 0.006). We did not identify significant differences in symptoms and QoL between COVID-19 infected children and the remaining cohort at the two time points. CONCLUSIONS An improvement of symptoms and QoL was observed during the quarantine, followed by a worsening at-follow-up. These findings reinforce the hypothesis that the nest effect overweighted COVID-19 fears during the quarantine and highlight the importance of psychological factors in symptom exacerbation.
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Affiliation(s)
- Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Peter Lu
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Michal Rozenfeld Bar Lev
- Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Faculty of Medicine, Tel Aviv University, Petach Tikvah, Israel
| | - Beate Beinvogl
- Boston Children's Hospital, Harvard medical School, Boston, Massachusetts, USA
| | - Carlo Di Lorenzo
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Sabrina Cenni
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Samuel Nurko
- Boston Children's Hospital, Harvard medical School, Boston, Massachusetts, USA
| | - Haley Pearlstein
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Rachel Rosen
- Boston Children's Hospital, Harvard medical School, Boston, Massachusetts, USA
| | - Raanan Shamir
- Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Faculty of Medicine, Tel Aviv University, Petach Tikvah, Israel
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
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Nishida Y, Hosomi S, Kobayashi Y, Nakata R, Ominami M, Nadatani Y, Fukunaga S, Otani K, Tanaka F, Nagami Y, Taira K, Kamata N, Fujiwara Y. Impact of the COVID-19 Pandemic on the Lifestyle and Psychosocial Behavior of Patients with Inflammatory Bowel Diseases: A Narrative Review. Healthcare (Basel) 2023; 11:2642. [PMID: 37830679 PMCID: PMC10572197 DOI: 10.3390/healthcare11192642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic has had a considerable impact on the global healthcare system and potentially the clinical course of patients with inflammatory bowel disease (IBD). Although IBD is a chronic disease, its therapy (except steroid therapy) does not increase the risk of contracting or aggravating COVID-19. However, the clinical course of patients is significantly influenced by environmental factors. Social restrictions due to the pandemic or the fear of contracting the virus have influenced lifestyle and psychosocial behaviors that may worsen the clinical course of patients with IBD. This narrative literature review summarizes the current evidence on the impact of the COVID-19 pandemic on the lifestyle and psychosocial behaviors of patients with IBD. The COVID-19 pandemic negatively affected the lifestyle and psychosocial behaviors of patients with IBD. Furthermore, patients with IBD failed to maintain medication adherence, thus affecting the clinical course of their condition.
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Affiliation(s)
| | - Shuhei Hosomi
- Department of Gastroenterology, Graduate School of Medicine, Osaka Metropolitan University Osaka, Osaka 530-0001, Japan
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Lee MH, Li HJ, Wasuwanich P, Kim SE, Kim JY, Jeong GH, Park S, Yang JW, Kim MS, Yon DK, Lee SW, Koyanagi A, Jacob L, Kim EY, Cheon JH, Shin JI, Smith L. COVID-19 susceptibility and clinical outcomes in inflammatory bowel disease: An updated systematic review and meta-analysis. Rev Med Virol 2023; 33:e2414. [PMID: 36504172 PMCID: PMC9877653 DOI: 10.1002/rmv.2414] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 11/08/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022]
Abstract
The susceptibility, risk factors, and prognosis of COVID-19 in patients with inflammatory bowel disease (IBD) remain unknown. Thus, our study aims to assess the prevalence and clinical outcomes of COVID-19 in IBD. We searched PubMed, EMBASE, and medRxiv from 2019 to 1 June 2022 for cohort and case-control studies comparing the prevalence and clinical outcomes of COVID-19 in patients with IBD and in the general population. We also compared the outcomes of patients receiving and not receiving 5-aminosalicylates (ASA), tumour necrosis factor antagonists, biologics, systemic corticosteroids, or immunomodulators for IBD. Thirty five studies were eligible for our analysis. Pooled odds ratio of COVID-19-related hospitalisation, intensive care unit (ICU) admission, or death in IBD compared to in non-IBD were 0.58 (95% confidence interval (CI) = 0.28-1.18), 1.09 (95% CI = 0.27-4.47), and 0.67 (95% CI = 0.32-1.42), respectively. Inflammatory bowel disease was not associated with increased hospitalisation, ICU admission, or death. Susceptibility to COVID-19 did not increase with any drugs for IBD. Hospitalisation, ICU admission, and death were more likely with 5-ASA and corticosteroid use. COVID-19-related hospitalisation (Odds Ratio (OR): 0.53; 95% CI = 0.38-0.74) and death (OR: 0.13; 95% CI = 0.13-0.70) were less likely with Crohn's disease than ulcerative colitis (UC). In conclusion, IBD does not increase the mortality and morbidity of COVID-19. However, physicians should be aware that additional monitoring is needed in UC patients or in patients taking 5-ASA or systemic corticosteroids.
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Affiliation(s)
- Min Ho Lee
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han Jacob Li
- University of Florida College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Paul Wasuwanich
- University of Florida College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Sung Eun Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jong Yeob Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gwang Hun Jeong
- Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Seoyeon Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae Won Yang
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Min Seo Kim
- Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
| | - Dong Keon Yon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea.,Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Eun-Young Kim
- Department of Health, Social and Clinical Pharmacy, Evidence-Based and Clinical Research Laboratory, College of Pharmacy, Chung-Ang University, Seoul, Korea
| | - Jae Hee Cheon
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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Batsiou A, Mantzios P, Piovani D, Tsantes AG, Kopanou Taliaka P, Liakou P, Iacovidou N, Tsantes AE, Bonovas S, Sokou R. SARS-CoV-2 Infection and Outcomes in Children with Inflammatory Bowel Diseases: A Systematic Review. J Clin Med 2022; 11:jcm11237238. [PMID: 36498812 PMCID: PMC9737360 DOI: 10.3390/jcm11237238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/03/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
The impact of COVID-19 on pediatric patients with inflammatory bowel disease (PIBD) is still not clear and the knowledge acquired over the last 2 years is still evolving. This study aims to investigate the risk and clinical outcomes of COVID-19 in patients with PIBD. A systematic search of PubMed and Scopus databases was conducted to identify studies published up until September 2022. Out of the 475 articles screened, 14 studies were included in the review. Of the 4006 children with PIBD included, 390 (9.7%) tested positive for COVID-19. Among those with COVID-19, 5.9% (0-16.7%) needed hospitalization, 0.6% (0-1%) were admitted to the pediatric intensive care unit (PICU), and no deaths were reported. Among the included studies, only four presented details regarding patients' symptoms, with 21% (0-25%) presenting gastrointestinal (GI) symptoms. An association between PIBD activity or specific treatment and COVID-19 outcome could not be established. The prevalence of COVID-19 in patients with PIBD was low; therefore, the initial concerns regarding higher infection risk and worse prognosis in this population are not supported by the currently available data. Further research is needed to determine the natural history of the infection and the optimal treatment for these patients. Much is still unclear and additional studies should be performed in order to optimize prevention and care for this special group of patients.
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Affiliation(s)
- Anastasia Batsiou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece
| | - Petros Mantzios
- Department of Internal Medicine, General Hospital of Eastern Achaia, 25100 Aigio, Greece
| | - Daniele Piovani
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
| | - Andreas G. Tsantes
- Microbiology Department, “Saint Savvas” Oncology Hospital, 11522 Athens, Greece
| | | | - Paraskevi Liakou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece
| | - Nicoletta Iacovidou
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Argirios E. Tsantes
- Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Stefanos Bonovas
- IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- Correspondence: (S.B.); (R.S.)
| | - Rozeta Sokou
- Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 18454 Piraeus, Greece
- Neonatal Department, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
- Correspondence: (S.B.); (R.S.)
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Health-Related Quality of Life in Pediatric Inflammatory Bowel Disease During COVID-19 Pandemic: A Prospective Study. J Pediatr Gastroenterol Nutr 2022; 75:595-600. [PMID: 35897141 DOI: 10.1097/mpg.0000000000003576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The aims of our study were to evaluate health-related quality of life (HRQoL) in children affected by inflammatory bowel disease (IBD) during the first wave of Coronavirus disease 2019 (COVID-19) pandemic and after 12 months. METHODS This was a single-center, prospective, observational study conducted between April 2020 and April 2021. Children from 10 to 18 years with a confirmed diagnosis of IBD were enrolled during the first COVID-19-related national quarantine. The following information was collected at the baseline and after 12 months: IBD subtype, location and phenotype, disease activity, current and previous therapies. Patients were asked to complete the PROMIS Anxiety and IMPACT III questionnaires. RESULTS One hundred and eighteen patients were enrolled, of whom 54 (46%) were affected by Crohn disease (CD) and 64 (54%) with ulcerative colitis (UC; median age: 15.5 years, range 10.3-18; M/F: 68/50). Median HRQoL was significantly decreased after 12 months compared with the beginning of COVID-19-related quarantine (T1: 76.7 vs T2: 72.8; P < 0.001). At 12 months, a higher number of children were reported to be in active disease when compared with the enrollment [T2: 22/108 (20.4%) vs T1: 12/118 (10%); P = 0.02]. Multivariate analysis showed a significant influence on HRQoL of quarantine period ( P < 0.001), female sex ( P = 0.016), biologic therapy ( P = 0.011), and active disease ( P < 0.001). CONCLUSIONS A deterioration of HRQoL after 12 months from COVID-19-related quarantine was observed. Additionally, the higher number of children with active disease at 12 months compared with enrollment may suggest detrimental consequences of the reduced disease control, contributing to decreased HRQoL.
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Robbertz AS, Cohen LL, Armistead LP, Reed B. Pandemic-Related Social Disruption and Well-Being in Pediatric Gastrointestinal Diseases. J Pediatr Psychol 2022; 47:981-990. [PMID: 35730966 PMCID: PMC9384296 DOI: 10.1093/jpepsy/jsac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has impacted everyone, but there are few data regarding how the pandemic has influenced the lives of children with gastrointestinal (GI) conditions. This cross-sectional study assessed pandemic-related social disruption (PRSD) in children with inflammatory bowel disease (IBD), celiac disease (CD), and irritable bowel syndrome (IBS), and the potential buffering effect of the parent-child relationship. METHODS A survey completed between September and December 2020 asked 146 children (ages 8-17) diagnosed with IBD (n = 44), CD (n = 81), or IBS (n = 51) and 185 parents how the pandemic has contributed to social disruption (i.e., financial stability, COVID-19 exposure, school changes, GI needs, and isolation) and their social-emotional well-being. Structural equation modeling was used to examine the role of social disruption on well-being, and the moderating effect of the parent-child relationship. RESULTS Increased social disruption predicted worse parent, β = 0.24, p = .02, and child well-being, β = 0.38, p < .01. The parent-child relationship moderated the relationship between parent and child well-being, β = 0.21, p = .03. Strong parent-child relationships predicted a positive association between parent and child well-being, β = 0.23, p = .003, whereas medium, β = 0.09, p = .14, and poor, β = -0.06, p = .52, relationships did not. CONCLUSIONS PRSD negatively impacted the well-being of children with GI conditions, and the parent-child relationship moderated this relationship. These findings are relevant to pediatric psychologists treating the physical and mental health needs of children with GI conditions and their parents.
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Affiliation(s)
| | | | | | - Bonney Reed
- Division of Gastroenterology, Hepatology, & Nutrition, Emory University School of Medicine, USA
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Avčin T, Avguštin Avčin B. Addressing mental health issues in immunocompromised adolescents with chronic diseases during the COVID-19 pandemic. J Pediatr (Rio J) 2022; 98:323-325. [PMID: 35366415 PMCID: PMC8958092 DOI: 10.1016/j.jped.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Tadej Avčin
- University Medical Center Ljubljana, Children's Hospital, Department of Allergology, Rheumatology and Clinical Immunology, Ljubljana, Slovenia; University of Ljubljana, Faculty of Medicine, Department of Pediatrics, Ljubljana, Slovenia.
| | - Bojana Avguštin Avčin
- University Psychiatric Hospital Ljubljana, Center for Mental Health, Ljubljana, Slovenia
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Lindoso L, Astley C, Queiroz LB, Gualano B, Pereira RMR, Tannuri U, Campos LMMDA, Lourenço B, Toma RK, Medeiros K, Watanabe A, Moreno Grangeiro P, Barros VDPMFR, Casella CB, Farhat S, Polanczyk GV, Silva CA. Physical and mental health impacts during COVID-19 quarantine in adolescents with preexisting chronic immunocompromised conditions. J Pediatr (Rio J) 2022; 98:350-361. [PMID: 34699770 PMCID: PMC8506207 DOI: 10.1016/j.jped.2021.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions during coronavirus disease 2019 (COVID-19) quarantine. METHODS A cross-sectional study included 355 adolescents with chronic conditions and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine, and the quarantine impact on physical and mental health. The validated self-reported version of the Strengths and Difficulties Questionnaire (SDQ) was also applied. RESULTS The median of age [14 (10-18) vs. 15 (10-18) years, p = 0.733] and frequencies of female (61% vs. 60%, p = 0.970) were similar between adolescents with preexisting chronic conditions and healthy adolescents during quarantine of COVID-19 pandemic. The frequencies of abnormal total difficulties score of SDQ were similar in patients and controls (30% vs. 31%, p = 0.775). Logistic regression analysis showed that being female (OR = 1.965; 95% CI = 1.091-3.541, p = 0.024), fear of underlying disease activity/complication (OR = 1.009; 95%CI = 1.001-1.018, p = 0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework (OR = 0.449; 95% CI = 0.206-0.981, p = 0.045) and physical activity (OR = 0.990; 95% CI = 0.981-0.999, p = 0.030) were protective factors. Further analysis of patients with chronic immunocompromised conditions and previous diagnosis of mental disorders (9%) compared with patients without diagnosis showed higher median of total difficulties score (p = 0.001), emotional (p = 0.005), conduct (p = 0.007), peer problems (p = 0.001) and hyperactivity (p = 0.034) in the former group. CONCLUSION Adolescents with preexisting chronic immunocompromised conditions during COVID-19 quarantine were not at higher risk of adverse health indicators. Being female, fear of underlying disease activity/complication, and household members working outside of the home were relevant issues for adolescents with preexisting chronic conditions. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during the pandemic.
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Affiliation(s)
- Livia Lindoso
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Camilla Astley
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Divisão de Reumatologia, São Paulo, SP, Brazil; Universidade de São Paulo (FMUSP), Faculdade de Medicina, Escola de Educação Física e Esporte, Grupo de Pesquisa em Fisiologia Aplicada e Nutrição, São Paulo, SP, Brazil
| | - Ligia Bruni Queiroz
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Bruno Gualano
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Divisão de Reumatologia, São Paulo, SP, Brazil; Universidade de São Paulo (FMUSP), Faculdade de Medicina, Escola de Educação Física e Esporte, Grupo de Pesquisa em Fisiologia Aplicada e Nutrição, São Paulo, SP, Brazil; Universidade de São Paulo, Centro de Pesquisa Alimentar, São Paulo, SP, Brazil
| | - Rosa Maria Rodrigues Pereira
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Divisão de Reumatologia, São Paulo, SP, Brazil
| | - Uenis Tannuri
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Lúcia Maria Mattei de Arruda Campos
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil; Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Divisão de Reumatologia, São Paulo, SP, Brazil
| | - Benito Lourenço
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Ricardo Katsuya Toma
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Karina Medeiros
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Andréia Watanabe
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Patricia Moreno Grangeiro
- Universidade de São Paulo (HCFMUSP), Faculdade Medicina, Hospital das Clínicas, Instituto de Ortopedia e Traumatologia, São Paulo, SP, Brazil
| | | | - Caio Borba Casella
- Universidade de São Paulo (FMUSP), Faculdade de Medicina, Departamento de Psiquiatria, São Paulo, SP, Brazil
| | - Sylvia Farhat
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil
| | - Guilherme Vanoni Polanczyk
- Universidade de São Paulo (FMUSP), Faculdade de Medicina, Departamento de Psiquiatria, São Paulo, SP, Brazil
| | - Clovis Artur Silva
- Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança e do Adolescente, São Paulo, SP, Brazil; Universidade de São Paulo (HCFMUSP), Faculdade de Medicina, Hospital das Clínicas, Divisão de Reumatologia, São Paulo, SP, Brazil.
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Moulin F, El-Aarbaoui T, Bustamante JJH, Héron M, Mary-Krause M, Rouquette A, Galéra C, Melchior M. Risk and protective factors related to children's symptoms of emotional difficulties and hyperactivity/inattention during the COVID-19-related lockdown in France: results from a community sample. Eur Child Adolesc Psychiatry 2022; 31:1-12. [PMID: 33751230 PMCID: PMC7942211 DOI: 10.1007/s00787-021-01752-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 02/23/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The COVID-19 epidemic has spread worldwide since December 2019. To contain it, preventive measures including social distancing, economic shutdown, and school closures were introduced, carrying the risk of mental health burden in adults and children. Although the knowledge base regarding children's response to trauma and adverse events in general has broadened, descriptions of their mental health during epidemics remain scarce. In particular, the role of family socioeconomic characteristics and parental mental health are poorly understood. METHODS We assessed the correlates of children's emotional difficulties and symptoms of hyperactivity/inattention during the COVID-19 lockdown in a French community-based sample. Data came from 432 community-based parents (27-46 years, TEMPO cohort) and their children (mean age 6.8 ± 4.1) interviewed online. Children's symptoms of emotional difficulties and hyperactivity/inattention were assessed using the parent-reported Strengths and Difficulties Questionnaire during the 5th week of home confinement. Family socioeconomic characteristics and parental mental health and substance use were assessed weekly during the first 5 weeks of home confinement. Data were analyzed using logistic regression models. RESULTS 7.1% of children presented symptoms of emotional difficulties and 24.7% symptoms of hyperactivity/inattention. Family financial difficulties and parental symptoms of anxiety and depression, as well as children's sleeping difficulties and screen time, were associated with the presence of psychological difficulties. CONCLUSION Children's emotional and behavioural difficulties are associated with parental mental health and socioeconomic difficulties. In the unprecedented situation of the COVID-19 epidemic, parents and professionals involved in caring for children should pay special attention to their mental health needs.
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Affiliation(s)
- Flore Moulin
- Bordeaux Population Health Research Center, INSERM U 1219, Bordeaux, France.
- Université de Bordeaux, Bordeaux, France.
| | | | | | - Mégane Héron
- INSERM Sorbonne Université, IPLESP, ERES UMRS 1136, Paris, France
| | | | - Alexandra Rouquette
- Université Paris-Saclay, UVSQ, Inserm, CESP, Paris, France
- AP-HP, Bicêtre Hospital, Public Health and Epidemiology Department, Le Kremlin-Bicêtre, France
| | - Cédric Galéra
- Bordeaux Population Health Research Center, INSERM U 1219, Bordeaux, France
- Université de Bordeaux, Bordeaux, France
- Department of Child and Adolescent Psychiatry, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Maria Melchior
- INSERM Sorbonne Université, IPLESP, ERES UMRS 1136, Paris, France
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Samji H, Wu J, Ladak A, Vossen C, Stewart E, Dove N, Long D, Snell G. Review: Mental health impacts of the COVID-19 pandemic on children and youth - a systematic review. Child Adolesc Ment Health 2022; 27:173-189. [PMID: 34455683 PMCID: PMC8653204 DOI: 10.1111/camh.12501] [Citation(s) in RCA: 366] [Impact Index Per Article: 183.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic's global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes. METHODS We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme. RESULTS Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes. CONCLUSIONS This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.
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Affiliation(s)
- Hasina Samji
- Faculty of Health SciencesSimon Fraser UniversityBurnabyBCCanada
- British Columbia Centre for Disease ControlVancouverBCCanada
- British Columbia Children’s Hospital Research InstituteVancouverBCCanada
| | - Judy Wu
- School of Population and Public HealthUniversity of British ColumbiaVancouverBCCanada
| | - Amilya Ladak
- Faculty of Health SciencesSimon Fraser UniversityBurnabyBCCanada
| | - Caralyn Vossen
- School of Population and Global HealthMcGill UniversityMontrealQCCanada
| | - Evelyn Stewart
- British Columbia Children’s Hospital Research InstituteVancouverBCCanada
- Division of Clinical and Behavioural NeurosciencesDepartment of PsychiatryFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
- British Columbia Mental Health and Substance Use Research InstituteVancouverBCCanada
| | - Naomi Dove
- School of Population and Public HealthUniversity of British ColumbiaVancouverBCCanada
| | - David Long
- Division of Clinical and Behavioural NeurosciencesDepartment of PsychiatryFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Gaelen Snell
- Faculty of Health SciencesSimon Fraser UniversityBurnabyBCCanada
- Faculty of MedicineUniversity of British ColumbiaVancouverBCCanada
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11
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Magalhães T, Granado MC, Manuel AR, Espinheira MDC, Trindade E. Impact of COVID-19 in Pediatric Patients and Young Adults with Inflammatory Bowel Disease. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2022; 20:1-6. [PMID: 35527801 PMCID: PMC9059000 DOI: 10.1159/000522073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022]
Abstract
Introduction Acute COVID-19 in pediatric and young adult patients tends to be milder in severity compared to adult infection. Recent studies seem to show that inflammatory bowel disease (IBD) patients are at no greater risk than the general population. We aim to describe our experience in the follow-up of pediatric and young adult patients with IBD followed in our center and determine possible risk factors of said population for severe COVID-19. Methods We performed a retrospective study of all patients aged under 25 years followed for IBD at the Unit of Pediatric Gastroenterology in a tertiary center between December 2019 and April 2021 evaluating the incidence of COVID-19 and characterization of positive cases. Results Of the 268 participants, 24 had COVID-19: the mean age was 19 years old and gender had an equal distribution; 75% (n = 18) had Crohn's disease, whereas only 25% (n = 6) had ulcerative colitis. Most patients were in clinical remission (n = 21). The majority of patients were under treatment with a tumor necrosis factor (TNF) antagonist (58%, n = 14), mainly infliximab, and most had no comorbidities other than IBD (83%). Regarding COVID-19, 17% of the patients were asymptomatic while the rest had only mild symptoms. There were no reported gastrointestinal complaints, no complications nor hospitalizations. Most patients did not require interruption of their IBD treatment. Conclusions Our data suggest that pediatric and young adult IBD patients have a low risk for complications and hospitalization, regardless of IBD treatment. We believe that this experience is encouraging and allows for safe counseling regarding treatment options and school attendance in pediatric and young adult IBD patients.
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Affiliation(s)
- Tiago Magalhães
- Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal
- Faculty of Medicine of the University of Porto, Porto, Portugal
- *Tiago Magalhães,
| | | | - Ana Rute Manuel
- Pediatrics Department, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal
| | - Maria do Céu Espinheira
- Faculty of Medicine of the University of Porto, Porto, Portugal
- Pediatric Gastroenterology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Eunice Trindade
- Pediatric Gastroenterology Unit, Pediatrics Department, Centro Hospitalar Universitário São João, Porto, Portugal
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12
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Strisciuglio C, Martinelli M, Lu P, Bar Lev MR, Beinvogl B, Benninga MA, Di Lorenzo C, Fiori Nastro F, Nurko S, Pearlstein H, Rosen R, Shamir R, Staiano A. Overall Impact of Coronavirus Disease 2019 Outbreak in Children With Functional Abdominal Pain Disorders: Results From the First Pandemic Phase. J Pediatr Gastroenterol Nutr 2021; 73:689-694. [PMID: 34417400 DOI: 10.1097/mpg.0000000000003286] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We aimed to assess how the first phase of coronavirus disease 2019 (COVID-19) pandemic influenced symptoms in children with functional abdominal pain disorders (FAPDs) and to characterize their quality of life (QoL), anxiety and global health. METHODS This was a multicenter, observational, international study conducted between April and July 2020 at six different referral centers. Children diagnosed with FAPDs between October 2019 and February 2020 were enrolled and prospectively interviewed at 4 months of follow-up during the first pandemic phase (Quarantine group). Patients were asked to complete PedsQL 4.0 Generic Core Scale and PROMIS Anxiety and Global Health questionnaires. A cohort of children diagnosed with FAPDs between October 2018 and February 2019 was used as a Control group. RESULTS Three-hundred-fifty-six children were enrolled of whom 180 (mean age at diagnosis: 14 ± 2.8 years) in the Quarantine group and 176 (mean age at diagnosis: 13 ± 2.8 years) in the Control group. At 4 months of follow-up, we observed a significant reduction of children reporting >5 episodes of abdominal pain per month when compared to baseline, in both groups (Quarantine group: 63.9% vs 42.2%, P < 0.001; Control group: 83.5% vs 50%, P < 0.001). The Quarantine group had median QoL values of 84.8 with 16.6% of children showing high anxiety values and 55% having decreased global health score. CONCLUSIONS We demonstrated symptoms' improvement at 4 months of follow-up in both cohorts. During the first months of the COVID-19 quarantine children with FAPDs showed satisfactory QoL and anxiety scores, suggesting positive effects of school closure and increased parental attention.
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Affiliation(s)
- Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Napoli
| | - Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Peter Lu
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Michal Rozenfeld Bar Lev
- Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Beate Beinvogl
- Boston Children's Hospital, Harvard medical School, Boston, MA
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carlo Di Lorenzo
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Francesca Fiori Nastro
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Samuel Nurko
- Boston Children's Hospital, Harvard medical School, Boston, MA
| | - Haley Pearlstein
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Rachel Rosen
- Boston Children's Hospital, Harvard medical School, Boston, MA
| | - Raanan Shamir
- Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
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13
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Graff LA, Fowler S, Jones JL, Benchimol EI, Bitton A, Huang JG, Kuenzig ME, Kaplan GG, Lee K, Mukhtar MS, Tandon P, Targownik LE, Windsor JW, Bernstein CN. Crohn's and Colitis Canada's 2021 Impact of COVID-19 and Inflammatory Bowel Disease in Canada: Mental Health and Quality of Life. J Can Assoc Gastroenterol 2021; 4:S46-S53. [PMID: 34755039 PMCID: PMC8570421 DOI: 10.1093/jcag/gwab031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/11/2021] [Indexed: 12/13/2022] Open
Abstract
There has been a dramatic rise in mental health difficulties during the coronavirus disease 2019 (COVID-19) pandemic. While young adults have the lowest risk of hospitalization and mortality due to COVID-19, they have been identified as being at highest risk of detrimental mental health outcomes during the pandemic, along with women, those with lower socioeconomic status and those with pre-existing mental health conditions. Somewhat of a crisis in mental health has emerged across the general population through the evolution of the pandemic. A national Canadian survey identified a quadrupling of those experiencing pervasive elevated anxiety symptoms early in the pandemic compared to pre-pandemic levels, and a doubling of those with pervasive elevated depressive symptoms. Independent of the pandemic, persons with inflammatory bowel disease (IBD) can face multiple challenges related to their disease, which can result in a significant psychosocial burden and psychologic distress. Anxiety and depression have been found to be more prevalent in persons with IBD. Many potential factors contribute to the increased psychologic distress and negative impacts on mental health of the COVID-19 pandemic on persons with IBD. These include the fears of contracting COVID-19 or infecting other people. Many believe that IBD or its treatments predispose them to an increased risk of COVID-19 or a worse outcome if acquired. Concerns about access to health care add to mental distress. People with IBD generally report lower quality of life (QOL) compared to community controls. Psychologic interventions, in addition to adequate disease control, have been shown to improve health-related QOL. Uncertainty is another factor associated with reduced health-related QOL. Most studies suggest that persons with IBD have suffered QOL impairment during the pandemic in comparison to the pre-pandemic period. Uncertainties brought on by the pandemic are important contributors for some of the reduction in QOL.
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Affiliation(s)
- Lesley A Graff
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada
| | - Sharyle Fowler
- Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jennifer L Jones
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eric I Benchimol
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Alain Bitton
- Department of Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - James Guoxian Huang
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - M Ellen Kuenzig
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.,Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | - Gilaad G Kaplan
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Kate Lee
- Crohn's and Colitis Canada, Toronto, Ontario, Canada
| | - Mariam S Mukhtar
- Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Laura E Targownik
- Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Joseph W Windsor
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Charles N Bernstein
- University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.,Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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14
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Koletzko L, Klucker E, Le Thi TG, Breiteneicher S, Rubio-Acero R, Neuhaus L, Stark RG, Standl M, Wieser A, Török H, Koletzko S, Schwerd T. Following Pediatric and Adult IBD Patients through the COVID-19 Pandemic: Changes in Psychosocial Burden and Perception of Infection Risk and Harm over Time. J Clin Med 2021; 10:4124. [PMID: 34575235 PMCID: PMC8464949 DOI: 10.3390/jcm10184124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND COVID-19-associated restrictions impact societies. We investigated the impact in a large cohort of inflammatory bowel disease (IBD) patients. METHODS Pediatric (pIBD) and adult patients and pIBD parents completed validated questionnaires for self-perceived stress (Perceived Stress Questionnaire, PSQ) and quality of life from July to October 2020 (1st survey) and March to April 2021 (2nd survey). Analyses were stratified by age groups (6-20, >20-40, >40-60, >60 years). Perceived risk of infection and harm from COVID-19 were rated on a 1-7 scale. An index for severe outcome (SIRSCO) was calculated. Multivariable logistic regression analysis was performed. RESULTS Of 820 invited patients, 504 (62%, 6-85 years) patients and 86 pIBD parents completed the 1st, thereof 403 (80.4%) the 2nd survey. COVID-19 restrictions resulted in cancelled doctoral appointments (26.7%), decreased physical activity, increased food intake, unintended weight gain and sleep disturbance. PSQ increased with disease activity. Elderly males rated lower compared to females or younger adults. PSQ in pIBD mothers were comparable to moderate/severe IBD adults. Infection risk and harm were perceived high in 36% and 75.4%. Multivariable logistic models revealed associations of higher perceived risk with >3 household members, job conditions and female gender, and of perceived harm with higher SIRSCO, unintended weight change, but not with gender or age. Cancelled clinic-visits were associated with both. SARS-CoV-2 antibodies prior 2nd infection wave were positive in 2/472 (0.4%). CONCLUSIONS IBD patients report a high degree of stress and self-perceived risk of complications from COVID-19 with major differences related to gender and age. Low seroprevalence may indicate altered immune response.
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Affiliation(s)
- Leandra Koletzko
- Department of Medicine II, LMU Klinikum, 81377 Munich, Germany; (L.K.); (S.B.); (L.N.); (H.T.)
| | - Elisabeth Klucker
- Department of Pediatrics, Dr von Hauner Kinderspital, LMU Klinikum, 80337 Munich, Germany; (E.K.); (T.G.L.T.); (T.S.)
| | - Thu Giang Le Thi
- Department of Pediatrics, Dr von Hauner Kinderspital, LMU Klinikum, 80337 Munich, Germany; (E.K.); (T.G.L.T.); (T.S.)
| | - Simone Breiteneicher
- Department of Medicine II, LMU Klinikum, 81377 Munich, Germany; (L.K.); (S.B.); (L.N.); (H.T.)
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, 80802 Munich, Germany; (R.R.-A.); (A.W.)
| | - Lukas Neuhaus
- Department of Medicine II, LMU Klinikum, 81377 Munich, Germany; (L.K.); (S.B.); (L.N.); (H.T.)
| | - Reneé G. Stark
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München, 85764 Neuherberg, Germany;
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany;
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, 80802 Munich, Germany; (R.R.-A.); (A.W.)
| | - Helga Török
- Department of Medicine II, LMU Klinikum, 81377 Munich, Germany; (L.K.); (S.B.); (L.N.); (H.T.)
| | - Sibylle Koletzko
- Department of Pediatrics, Dr von Hauner Kinderspital, LMU Klinikum, 80337 Munich, Germany; (E.K.); (T.G.L.T.); (T.S.)
- Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum University of Warmia and Mazury, 10-719 Olsztyn, Poland
| | - Tobias Schwerd
- Department of Pediatrics, Dr von Hauner Kinderspital, LMU Klinikum, 80337 Munich, Germany; (E.K.); (T.G.L.T.); (T.S.)
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15
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Corrias A, Cortes GM, Bardanzellu F, Melis A, Fanos V, Marcialis MA. Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8090753. [PMID: 34572185 PMCID: PMC8468140 DOI: 10.3390/children8090753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 12/15/2022]
Abstract
Susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases (IBD) are unclear and epidemiological data on the topic are still limited. There is some concern that patients with immuno-mediated diseases such as IBD, which are frequently treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 infection with its related serious adverse outcomes, including intensive care unit (ICU) admission and death. Corticosteroids, immunomodulators, and biologic drugs, which are commonly prescribed to these patients, have been associated with higher rates of severe viral and bacterial infections including influenza and pneumonia. It is not known whether these drugs can be so harmful as to justify their interruption during COVID-19 infection or if, on the contrary, patients with IBD can benefit from them. As shown by recent reports, it cannot be excluded that drugs that suppress the immune system can block the characteristic cytokine storm of severe forms of COVID-19 and consequently reduce mortality. Another cause for concern is the up-regulation of angiotensin converting enzyme-2 (ACE2) receptors that has been noticed in these patients, which could facilitate the entry and replication of SARS-CoV-2. The aim of this narrative review is to clarify the susceptibility of SARS-CoV-2 infection in patients with IBD, the clinical characteristics of patients who contract the infection, and the relationship between the severity of COVID-19 and immunosuppressive treatment.
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16
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Dipasquale V, Passanisi S, Cucinotta U, Cascio A, Romano C. Implications of SARS-COV-2 infection in the diagnosis and management of the pediatric gastrointestinal disease. Ital J Pediatr 2021; 47:71. [PMID: 33761992 PMCID: PMC7988257 DOI: 10.1186/s13052-021-01020-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
Gastrointestinal diseases such as celiac disease, functional gastrointestinal disorders (FGIDs), inflammatory bowel disease (IBDs) and acute or chronic diarrhea are quite frequent in the pediatric population. The approach, the diagnosis and management can be changed in the 2019 coronavirus disease (COVID-19) pandemic era. This review has focused on: i) the current understanding of digestive involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected children and adolescents and the clinical implications of COVID-19 for pediatric gastroenterologists, ii) the impact of COVID-19 on the clinical approach to patients with pre-existing or onset diseases, including diagnosis and treatment, and iii) the role and limited access to the instrumental diagnosis such as digestive endoscopy. To date, it is unclear if immunosuppression in patients with IBD and chronic liver disease represents a risk factor for adverse outcomes. Scheduled outpatient follow-up visits may be postponed, especially in patients in remission. Conversely, telemedicine services are strongly recommended. The introduction of new therapeutic regimens should be made on an individual basis, discussing the benefits and risks with each patient. Furthermore, psychological care in all children with chronic disease and their parents should be ensured. All non-urgent and elective endoscopic procedures may be postponed as they must be considered at high risk of viral transmission. Finally, until SARS-CoV-2 vaccination is not available, strict adherence to standard social distancing protocols and the use of personal protective equipment should continue to be recommended.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Stefano Passanisi
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy.
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17
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Arrigo S, Alvisi P, Banzato C, Bramuzzo M, Celano R, Civitelli F, D'Arcangelo G, Dilillo A, Dipasquale V, Felici E, Fuoti M, Gatti S, Knafelz D, Lionetti P, Mario F, Marseglia A, Martelossi S, Moretti C, Norsa L, Panceri R, Renzo S, Romano C, Romeo E, Strisciuglio C, Martinelli M. Impact of COVID-19 pandemic on the management of paediatric inflammatory bowel disease: An Italian multicentre study on behalf of the SIGENP IBD Group. Dig Liver Dis 2021; 53:283-288. [PMID: 33388247 PMCID: PMC7832380 DOI: 10.1016/j.dld.2020.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND IBD management has been significantly affected during the COVID-19 lockdown with potential clinical issues. AIMS The aim of this study was to analyse the impact of COVID-19 pandemic on the Italian paediatric IBD cohort. METHODS This was a multicentre, retrospective, cohort investigation including 21 different Italian IBD referral centres. An electronic data collection was performed among the participating centres including: clinical characteristics of IBD patients, number of COVID-19 cases and clinical outcomes, disease management during the lockdown and the previous 9 weeks. RESULTS 2291 children affected by IBD were enrolled. We experienced a significant reduction of the hospital admissions [604/2291 (26.3%) vs 1281/2291 (55.9%); p < 0.001]. More specifically, we observed a reduction of hospitalizations for new diagnosis (from n = 44 to n = 27) and endoscopic re-evaluations (from n = 46 to n = 8). Hospitalization for relapses and surgical procedures remained substantially unchanged. Biologic infusions did not significantly vary [393/2291 (17.1%) vs 368/2291 (16%); p = 0.3]. Telemedicine services for children with IBD were activated in 52.3% of the centres. In 42/2291(1.8%) children immunosuppressive therapies were adapted due to the concurrent COVID-19 pandemic. CONCLUSION Due to the several limitations of the lockdown, cares for children with IBD have been kept to minimal standards, giving priorities to the urgencies and to biologics' infusions and implementing telemedicine services.
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Affiliation(s)
- Serena Arrigo
- Pediatric Gastroenterology and Endoscopy Unit, Institute 'Giannina Gaslini', Genoa, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Claudia Banzato
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health, IRCCS Burlo Garofalo, Trieste, Italy
| | - Rosaria Celano
- Fondazione IRCCS Ca' Grande, Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy
| | - Fortunata Civitelli
- Department of Gender diseases, Child and Adolescent health, Pediatric unit, Sant'Eugenio Hospital, Rome, Italy
| | - Giulia D'Arcangelo
- Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy
| | - Anna Dilillo
- Pediatric and Neonatology Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Valeria Dipasquale
- Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age ``Gaetano Barresi'', University of Messina, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Maurizio Fuoti
- Pediatric Gastroenterology and GI Endoscopy, University Department of Pediatrics, Children's Hospital, Spedali Civili, Brescia, Italy
| | - Simona Gatti
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| | - Daniela Knafelz
- Hepatology and Gastroenterology Unit, Bambino Gesù Hospital, Rome, Italy
| | | | | | - Antonio Marseglia
- Fondazione IRCCS Casa Sollievo della Sofferenza, Division of Pediatrics, San Giovanni Rotondo, Italy
| | | | - Chiara Moretti
- Paediatrics Division, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Norsa
- Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Roberto Panceri
- Department of Pediatrics, University of Milano-Bicocca, Foundation MBBM/San Gerardo Hospital, Monza, Italy
| | - Sara Renzo
- University of Florence-Meyer Hospital, Florence, Italy
| | - Claudio Romano
- Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age ``Gaetano Barresi'', University of Messina, Italy
| | - Erminia Romeo
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania ``Luigi Vanvitelli'', Naples, Italy
| | - Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Italy.
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18
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Cheema M, Mitrev N, Hall L, Tiongson M, Ahlenstiel G, Kariyawasam V. Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey. BMJ Open Gastroenterol 2021; 8:bmjgast-2020-000581. [PMID: 33579729 PMCID: PMC7883604 DOI: 10.1136/bmjgast-2020-000581] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/10/2021] [Accepted: 01/14/2021] [Indexed: 12/20/2022] Open
Abstract
Background The global COVID-19 pandemic has impacted on the mental health of individuals, particularly those with chronic illnesses. We aimed to quantify stress, anxiety and depression among individuals with Inflammatory bowel disease (IBD) in Australia during the pandemic. Methods An electronic survey was made available to IBD patients Australia-wide from 17 June to 12 July 2020. Respondents with an underlying diagnosis of IBD and over 18 years of age were included. A validated questionnaire (Depression, Anxiety, Stress Score-21, DASS21) was used to assess depression, anxiety and stress. Data on potential predictors of depression, anxiety and stress were collected. Results 352 participated in the survey across Australia. 60.5% of respondents fulfilled DASS criteria for at least moderate depression, anxiety or stress. 45% reported a pre-existing diagnosis of depression and/or anxiety. Over 2/3 of these respondents reported worsening of their pre-existing depression/anxiety due to the current pandemic. Of those without a pre-existing diagnosis of anxiety or depression, high rates of at least moderate to severe depression (34.9%), anxiety (32.0%) and stress (29.7%) were noted. Younger age (OR 0.96, 95% CI 0.94 to 0.98, p<0.001), lack of access to an IBD nurse (OR 1.81, 95% CI 1.03 to 3.19, p=0.04) and lack of education on reducing infection risk (OR 1.99, 95% CI 1.13 to 3.50, p=0.017) were associated with significant stress, anxiety and/or depression. Conclusion High prevalence of undiagnosed depression, anxiety and stress was identified among respondents. Improved access to IBD nurse support and greater attention to education are modifiable factors that may reduce depression, anxiety and/or stress among patients with IBD during the pandemic.
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Affiliation(s)
- Madiha Cheema
- Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia
| | - Nikola Mitrev
- Department of Gastroenterology, Western Sydney University Blacktown Mount Druitt Medical School, Blacktown, New South Wales, Australia
| | - Leanne Hall
- Complete Health Australia, Rouse Hill, New South Wales, Australia
| | - Maria Tiongson
- Department of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia
| | - Golo Ahlenstiel
- Department of Gastroenterology, Western Sydney University Blacktown Mount Druitt Medical School, Blacktown, New South Wales, Australia.,Department of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia
| | - Viraj Kariyawasam
- Department of Gastroenterology, Western Sydney University Blacktown Mount Druitt Medical School, Blacktown, New South Wales, Australia.,Department of Gastroenterology, Blacktown Hospital, Blacktown, New South Wales, Australia
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19
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Puoti MG, Rybak A, Kiparissi F, Gaynor E, Borrelli O. SARS-CoV-2 and the Gastrointestinal Tract in Children. Front Pediatr 2021; 9:617980. [PMID: 33692973 PMCID: PMC7937901 DOI: 10.3389/fped.2021.617980] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/22/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly a respiratory disease. However, its significant impact on the gastrointestinal (GI) system is now well-known. SARS-CoV-2 enters cells via the angiotensin-converting enzyme-2 (ACE-2) receptor, which is abundantly expressed on lung cells, but also on enterocytes. Several etiopathogenetic mechanisms have been postulated to explain the GI involvement in COVID-19, including loss in intestinal absorption, microscopic mucosal inflammation and impaired ACE-2 function, which plays a significant role in maintaining gut homeostasis. In children the GI manifestations include anorexia, nausea, vomiting, diarrhea and abdominal pain, which may represent the earliest presenting symptoms of the disease. However, although rare, a significant GI mucosal inflammation, such as terminal ileitis mimicking an atypical appendicitis, and other GI manifestations have been reported. COVID-19 pandemic has posed a significant challenge in healthcare provision in term of ability in providing safe diagnostic procedures, face-to-face consultations, and offering comprehensive care. For instance, changes in health services have raised the risk of empirical or sub-optimal management of chronic GI disorders such as inflammatory bowel disease (IBD) due to delayed endoscopic and clinical assessment. This review will discuss the acute GI involvement in COVID-19 in children and reflect on challenges and major changes observed in clinical practice during COVID-19 pandemic by sharing both the published literature and personal experience. We also suggest potential strategies for providing optimal gastroenterology care during this unprecedented era.
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20
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Arrigo S, Alvisi P, Banzato C, Bramuzzo M, Civitelli F, Corsello A, D'Arcangelo G, Dilillo A, Dipasquale V, Felici E, Fuoti M, Gatti S, Giusti Z, Knafelz D, Lionetti P, Mario F, Marseglia A, Martelossi S, Moretti C, Norsa L, Nuti F, Panceri R, Rampado S, Renzo S, Romano C, Romeo E, Strisciuglio C, Martinelli M. Management of paediatric IBD after the peak of COVID-19 pandemic in Italy: A position paper on behalf of the SIGENP IBD working group. Dig Liver Dis 2021; 53:183-189. [PMID: 33132063 PMCID: PMC7580561 DOI: 10.1016/j.dld.2020.10.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/15/2020] [Accepted: 10/18/2020] [Indexed: 12/11/2022]
Abstract
Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2, spreading in Italy during the first months of 2020, abruptly changed the way of practicing medicine in this country. As a consequence of the lockdown, the diagnostic and therapeutic management of paediatric chronic conditions, such as inflammatory bowel disease (IBD) has been affected. During the peak of COVID-19 pandemic, elective visits, endoscopies and infusions have been postponed, with potential clinical and psychological impact on disease course and a high likelihood of increasing waiting lists. While slowly moving back towards normality, clinicians need to recognize the best ways to care for patients with IBD, carefully avoiding risk factors for new potential epidemic outbreaks. In this uncertain scenario until the development and spread of COVID-19 vaccine, it is necessary to continue to operate with caution. Hereby we provide useful indications for a safer and gradual restarting of routine clinical activities after COVID-19 peak in Italy.
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Affiliation(s)
- Serena Arrigo
- Pediatric Gastroenterology and Endoscopy Unit, Institute 'Giannina Gaslini', Genoa, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Claudia Banzato
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Division, University of Verona, Verona, Italy
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health, IRCCS Burlo Garofalo, Trieste, Italy
| | - Fortunata Civitelli
- Department of Gender diseases, Child and Adolescent health, Pediatric unit, Sant'Eugenio Hospital, Rome, Italy
| | - Antonio Corsello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, OU Internal Medicine and Gastroenterology, Rome, Italy
| | - Giulia D'Arcangelo
- Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy
| | - Anna Dilillo
- Pediatric and Neonatology Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy
| | - Valeria Dipasquale
- Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Maurizio Fuoti
- Pediatric Gastroenterology and GI Endoscopy, University Department of Pediatrics, Children's Hospital, Spedali Civili, Brescia, Italy
| | - Simona Gatti
- Department of Pediatrics, Università Politecnica delle Marche, Ancona, Italy
| | - Zeno Giusti
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", , Via S. Pansini, 5, 80131 Naples, Italy
| | - Daniela Knafelz
- Hepatology and Gastroenterology Unit, Bambino Gesù Hospital, Rome, Italy
| | | | | | - Antonio Marseglia
- Fondazione IRCCS Casa Sollievo della Sofferenza, Division of Pediatrics, San Giovanni Rotondo, Italy
| | | | - Chiara Moretti
- Paediatrics Division, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Norsa
- Paediatric Hepatology Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Federica Nuti
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy
| | - Roberto Panceri
- Department of Pediatrics, University of Milano-Bicocca, Foundation MBBM/San Gerardo Hospital, Monza, Italy
| | | | - Sara Renzo
- University of Florence-Meyer Hospital, Florence, Italy
| | - Claudio Romano
- Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - Erminia Romeo
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", , Via S. Pansini, 5, 80131 Naples, Italy.
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21
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Papa A, Papa V, Lopetuso LR, Gasbarrini A, Tursi A. Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase. Therap Adv Gastroenterol 2020; 13:1756284820968747. [PMID: 33149764 PMCID: PMC7586260 DOI: 10.1177/1756284820968747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/01/2020] [Indexed: 02/04/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised several concerns for patients with chronic immune-mediated diseases, including inflammatory bowel disease (IBD). As the outbreak appears to be in the descending phase, at least in some part of the world, as in most European countries, guidance is urgently needed to provide optimal care for our IBD patients in order to gradually and safely reduce the gap in care that has been accumulated in the months of lockdown and to face all the backlogs. Therefore, we have provided a decalogue of practical recommendations for gastroenterologists to manage patients with IBD in the post-peak phase of the COVID-19 pandemic. They include all the aspects of IBD care, not only pharmacological ones but also endoscopy, surgery, psychological treatment, telemedicine, diagnostics and educational tasks provided by doctors and patient associations.
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Affiliation(s)
| | - Valerio Papa
- Catholic University, Rome, Italy,Department of Digestive Surgery, Policlinico Universitario “A. Gemelli” IRCCS Foundation, Rome, Italy
| | - Loris Riccardo Lopetuso
- Department of Medical and Surgical Sciences, Division of Internal Medicine and Gastroenterology, Policlinico Universitario “A. Gemelli” IRCCS Foundation, Rome, Italy,Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy,Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Antonio Gasbarrini
- Department of Medical and Surgical Sciences, Division of Internal Medicine and Gastroenterology, Policlinico Universitario “A. Gemelli” IRCCS Foundation, Rome, Italy Catholic University, Rome, Italy
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22
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Serlachius A, Badawy SM, Thabrew H. Psychosocial Challenges and Opportunities for Youth With Chronic Health Conditions During the COVID-19 Pandemic. JMIR Pediatr Parent 2020; 3:e23057. [PMID: 33001834 PMCID: PMC7553787 DOI: 10.2196/23057] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023] Open
Abstract
School closures, altered access to health services, and economic stress during the COVID-19 pandemic have likely had an impact on the mental and physical well-being of youth worldwide, particularly among those with chronic health conditions (CHCs). A number of challenges and opportunities have emerged during the COVID-19 pandemic for youth with CHCs. Challenges include heightened anxiety, disrupted routines, academic and social stresses associated with school closure, increased risk of domestic violence and abuse, and reduced access to physical and psychosocial support. On the other hand, opportunities include reduced academic and social stress, increased time with families, reduced access to substances, easier access to health care using technology, and opportunities to build resilience. This viewpoint paper highlights both challenges and opportunities for youth with CHCs during the pandemic and offers recommendations for further research and clinical care.
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Affiliation(s)
- Anna Serlachius
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sherif M Badawy
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Division of Hematology, Oncology and Stem Cell Transplant, Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Hiran Thabrew
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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