ABSTRACT
Background And Aim: Data From The First Wave Of Covid-19 Pan-Demic Suggested That Patients With Inflammatory Bowel Disease (Ibd) Are Not At Higher Risk Of Being Infected By Sars-Cov-2 Than The General Population And That, In Case Of Covid-19, Treatment With Immunomodulatory Drugs Is Not Associated With Worse Prognosis, With The Possible Exception Of Systemic Steroids. Evidence From The Second Wave Of Covid-19 Pandemic Is Required To Confirm These Findings. Materials And Methods: This Retrospective Observational Study Included Consecutive Ibd Patients Of The Cohort Of The Sicilian Network For Inflammatory Bowel Disease (Sn-Ibd) With Covid-19 Diagnosed By Pcr-Confirmed Presence Of Sars-Cov-2 Genome In A Nasopharyngeal Swab During The Second Covid-19 Pandemic Wave (15th September 2020–15th January 2020). Data Regarding Demo-Graphics, Ibd Features And Treatments, Comorbidities, And Symptoms Of Covid-19 Were Related To Covid-19 Clinical Outcomes. Results: One Hundred Twenty-Two Patients (Mean Age 43.9±16.7 Years;Males 50.0%;Crohn’S Disease 62.3%;Ulcerative Colitis: 37.7%) Were Included (Estimated Cumulative Incidence: 122/10,000 Ibd Patients=0.0122%). Twelve Patients Developed Covid-19-Related Pneumonia (9.8%), 4 (3.3%) Required Respiratory Assistance (Non-Mechanical Ventilation Or Orotracheal Intubation), And 4 Died (Case Fatality Rate: 3.3%). At Multivariate Analysis, Age (Or 1.034, 95% Ci 1.006-1.147, P=0.03) And Severe Ibd Activity (Or 13.465, 95% Ci 1.104-164.182, P=0.04) Were Independent Predictors Of Covid-19-Related Pneumonia, While Severe Ibd Activity (Or 15.359, 95% Ci 1.320-178.677, P=0.03) Was The Only Independent Predictor Of Severe Covid-19, A Composite End-Point Defined As Need For Respira-Tory Assistance And/Or Death. Concomitant Ibd Treatments Were Not Associated With Covid-19 Clinical Outcomes, Even If A Trend Toward A Protective Role Of Tnf-Inhibitors On Pneumonia Development Was Reported (P=0.08). Conclusions: In This Large Cohort Of Patients With Ibd And Covid-19, Severe Ibd Activity Was The Only Risk Factor For Severe Covid-19, While Ibd Treatments Were Not Associated With Worse Outcomes
ABSTRACT
BACKGROUND: The social consequences of COVID-19 pandemic are universally known. In particular, the pediatric population is dealing with a radical lifestyle change. For some risk categories, such as overweight or obese children, the impact of home confinement has been greater than for others. The increased sedentary life, the wrong diet and social distancing have stopped the chance of losing weight. The aims of this study were to analyse the impact of COVID-19 lockdown on the behavior changes in a obese pediatric population and to explore the correlation between the new lifestyle and the level of parental instruction. METHODS: Data show features of 40 obese and overweight pediatric patients of our Clinic in Messina (Italy). We evaluated weight, height, BMI and other biochemical parameters: total cholesterol, HDL, LDL, triglyceride, transaminases, glycemia and insulinemia. After the lockdown, we contacted all patients in order to get some information about diet, physical activity and sedentary lifestyle changes in correlation to the level of their parents' instruction. Additionally, we also evaluated 20 children twice from a clinical and laboratory perspective. RESULTS: The study showed an increase of daily meals during COVID-19 lockdown (3.2 ± 0.4 vs 5 ± 1, P < 0.001). In particular, children whose parents have primary school diploma ate a greater significant number of meals during the lockdown, compared to those who have parents with secondary school diploma (P = 0.0019). In addition, the 95% of patients did low physical activity during the lockdown and the 97.5% spent more time in sedentary activity. Even if BMI's values don't show significant differences, they have increased after the lockdown. We didn't find any correlation between biochemical parameters before and after the lockdown. CONCLUSION: The lockdown has had bad consequences on good style of life's maintenance in overweight and obese children. The absence of a significant correlation between the worsening of biochemical parameters and the lockdown doesn't allow to exclude any long-term consequences. It's safe to assume that, if the hours spent in sedentary activity and the number of meals don't diminish, there will probably repercussion on the biochemical parameters.