ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) has spread quickly. Comorbidities, such as diabetes, have been determined as critical risk factors for COVID-19. Objective(s): This study aimed to determine the frequency and severity of diabetic ketoacidosis (DKA) in children before and during the COVID-19 pandemic. Method(s): This retrospective study examined children aged less than 18 years diagnosed with DKA hospitalized in Yazd Shahid Sadoughi Hospital from February 20, 2020, to November 21, 2021. The collected information was compared to those obtained during the same period in 2019 (pre-pandemic). According to the inclusion criteria, only children with suspected symptoms of COVID-19 or an infected family member underwent PCR. Result(s): The study included 70 children with confirmed DKA during the COVID-19 pandemic and 33 children hospitalized during the pre-pandemic period. The findings showed that the rate of DKA was higher during the pandemic than in the pre-pandemic period. In the DKA subgroups (during the COVID-19 pandemic vs. pre-pandemic), 35.7% vs. 21.2% were severe, 37.1% vs. 36.4% were moderate, and 27.1% vs. 42.4% were mild. Of 70 children, 30 underwent PCR tests for COVID-19, showing six positive cases. Among positive cases, five had mild symptoms, while one was hospitalized with signs of respiratory distress, polyuria, and polydipsia. All physical examinations of this patient were normal, except for the chest exam. Conclusion(s): A remarkable increase was observed in the frequency and severity of DKA in children during the pandemic.Copyright © 2023, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
ABSTRACT
Background: With the global spread of COVID-19, many families have experienced the physical or psychological effects of the disease, which has had a profound impact on children.Objectives: Given that most studies have assessed the effects of COVID-19 on physical health, this study reviews the psychological and psychosomatic aspects of the disease and possible solutions to improve the condition of children and adolescents regardless of physical problems and complications of COVID-19.Methods: The data employed in our narrative review were searched for English documents published between 2019 and 2022 in EMBASE, Web of Science, Scopus, Google Scholar, and PubMed databases. Keywords included Mental health, Grief, Anxiety, depression, Children, and COVID-19. After screening the s, the full text of 70 related studies was reviewed, and finally, 52 relevant surveys were selected.Results: Among the most important issues are the irreparable effects of losing a parent or the death of a loved one due to this disease (loss and grief) and a wide range of other disorders, such as feelings of fear, anxiety, depression, sleep problems, and post-traumatic stress disorder. However, the destructive effects of prolonged school closures and turning to social media without parental supervision and adequate infrastructure for children cannot be ignored.Conclusions: Children's reactions to stress are different, such as overdependence, anxiety, withdrawal, anger, bedwetting, etc. Long-term quarantine and its consequences have increased anxiety and depression, sleep disorders, and nutritional problems in children and adolescents. Therefore, children need a safe and supportive environment, guidance, and help to express their fear and sadness.