ABSTRACT
Background: Since the identification of a cluster of pneumonia cases in China (Wuhan) in December 2019, the COronaVIrus Disease-19 (COVID-19) outbreak rapidly spread across different countries. Italy was the first European Country to face COVID-19 Emergency and one of the most affected. The COVID-19 Emergency has forced people to change everyday life habits in response to restrictions, stimulating people's feelings of fear and physical health threat, increasing the risk of psychological adverse outcomes, such as anxiety, depression and Post-Traumatic Stress Symptoms (PTSS) [1]. A severe illness in one's child is acknowledged to be a destabilizing event, having a negative impact on parent psychological wellbeing with an increased risk of negative mental health consequences, among which PTSS throughout the development of Post-Traumatic Stress Disorder (PTSD) [2,3]. Consistently with this evidence, parents who interfaced with suspected COVID-19 infection in their children, particularly in the early acute phase of the pandemic, may have resulted a challenging population at risk for negative psychological consequences [4]. However, scant data explored this issue. Objective: The aim of the present study was to investigate psychological outcomes on parents who accessed Pediatric Emergency Departments of three University Hospitals in Italy (Azienda Ospedaliero-Universitaria Pisana, Pisa;Azienda Ospedaliero-Universitaria Sant'Orsola Malpighi, Bologna;Fondazione IRCSS Policlinico San Matteo, Pavia) for symptoms of suspicious COVID-19 in their children during the acute phase of the COVID-19 outbreak (April, 2020), with particular attention to the onset of PTSS. Methods: 110 parents of children with suspected COVID-19 were recruited within one month from diagnostic assessment for COVID-19 and were assessed through the Impact of Event Scale-Revised (IES-R), to evaluate PTSS. Comparison of socio-demographic and clinical features between subjects with and without PTSS was performed. A logistic regression model was used to identify the factors associated with the development of PTSS. Results: 39 (35.4%) parents reported moderate to severe PTSS (IES-R score≥24). Results showed parents of children tested positive for COVID-19 being more prone to develop PTSS as compared to those whose children were negative (p<0.001). Similarly, PTSS rates were significantly higher among mothers with respect to fathers (p=0.012), among those tested positive themselves for COVID-19 compared to those negative (p=0.026) and among those who received indication to quarantine with respect to ones who had not (p<0.001). Mean age of participants was significantly lower among subjects with PTSS than those without (p=0.025). Finally, having a child tested positive for COVID-19 showed a positive association with the onset of PTSS (p=0.007). Conclusions: These results highlight the traumatic burden of children's illness on parents, particularly on the mothers that, besides representing the most vulnerable gender to post-traumatic stress reactions, often represent the principal caregiver and suggest the need of further studies to address tailored prevention and intervention strategies, also in the framework of the ongoing COVID-19 pandemic. No conflict of interest
ABSTRACT
BACKGROUND: The recent COVID-19 pandemic pointed out new burdens for researchers on mental health and that evidence-based (EB) studies on vulnerable populations are timely needed. The present paper aims at analysing the impact of suspicious of SARS-COV-2 infection in a cohort of parents presented at 3 major hospitals (spread between north and center of Italy) during the Italian COVID-19 pandemic phase 1. METHODS: Participants of the present cross-sectional, multicenter study were parental couples of children suspected to have COVID-19 who underwent testing with nasopharyngeal swabbing. All subjects were assessed by means of the: Impact of Event Scale-Revised (IES-R), Generalized Anxiety Disorder 7-Item (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) in order to evaluate Post-traumatic stress (PTSS), anxiety, and depressive symptoms, respectively. OUTCOMES: Results evidenced that parents whose children tested positive for COVID-19 were more prone to developing PTSS, anxiety and depressive symptoms. The same results emerged for parents who had quarantined as opposed to those who had not. Moreover, patients who suffered economic damage showed a higher prevalence of anxiety and depressive symptoms, whereas PTSS was more common among unemployed subjects and among mothers. INTERPRETATION: This study identified a mental health strain represented by parenting a child who tested positive for SARS-CoV-2 infection. Further EB research is needed to develop evidence-driven strategies to reduce adverse psychological impacts and related psychiatric symptoms in caregivers of COVID-19 infected children during the next phases of the pandemic.