COVID-19 Pandemic Effects on Adolescent Neuropsychiatric Patients in Emergency Department (preprint)

Objective: Italy was the first country affected in Europe by the new coronavirus disease pandemic, so a national lockdown was set up. Side effects were anxiety, discomfort and social pressure, among others. This study analyses the characteristics of adolescent who required emergency help for neuropsychiatric disorders in the year before and after lockdown beginning. Methods: : Data were collected from 1428 patients aged 12-18 years who enter the Emergency Department with a diagnosis of neuropsychiatric disorders in a pediatric tertiary Hospital in Rome, between March 2019 and March 2021. Results: : History of previous neuropsychiatric episodes (p<0.001) and comorbidities (p=0.003) were more frequent in the pre-covid era. During post-lockdown, onset time of acute symptoms was longer (p<0.001) and number of hospitalizations was higher (p<0.001) but their length was the same. Psychomotor agitation was less frequent during post-lockdown period (p<0.001); there was a reduction in hetero-aggressiveness (p=0.005) but increment in suicidal ideation (p=0.002) and suicide attempt (p<0.001). Conclusion: Rates of suicide ideation and attempts were higher during some months but admission for psychomotor agitation was reduced after lockdown, probably due to protective factors, like anxiety reduction referred to school performances and the major presence of parents at home. First lockdown forced children and parents at home; second lockdown left children lonely for most of the day. Patients waited longer before going to the emergency room in the post-lockdown phase, probably because the media focus on pandemic and the fear of contagion in hospital. Breaks in schooling can lead to educational inequalities over time.

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

Purpose: Since the beginning of COVID-19 pandemic, social distancing and home-confinement had a significant impact on children, especially on those with eating disorders (ED). The primary objective of this retrospective study was to describe and analyze the demographic and clinical profiles of children presenting with ED during the COVID-19 pandemic. Methods: We conducted a retrospective review of clinical charts of patients with ED younger than 18 years who accessed the emergency department of the Bambino Gesù Children's Hospital, Rome, between March 2019 and March 2021. Of these, we reported and compared the demographic, clinical and laboratory data before and after the COVID-19 pandemic and looked for predictors of ED severity. Results: A total of 211 admissions for ED were recorded. The patients, mostly females (86.3%) were on average 14.1 years old. The mean weight loss on admission was 11 kg. Bradycardia was observed in 31.3% of the study sample. 16.6% of patients had an associate psychiatric disorder and 60.2% required psychotropic drugs. 68.7% of the patients required hospitalization. Respectively, 96 and 115 patients were admitted before and during the COVID-19 pandemic. The latter were hospitalized more (78.3 vs 57.3%; p=0.001), yet for less time (19 vs 26 days; p=0.004), had a higher mean serum creatinine (0.68 vs 0.47; p<0.001) and were more frequently diagnosed with an associated psychiatric disorder (23.5 vs 8.3%; p=0.003). Conclusion: Our study shows a significant increase of hospitalizations of children with ED during the COVID-19 pandemic, along with a shorter length of stay, more psychiatric comorbidities, and some distinctive features at the laboratory workup, such as an increase of serum creatinine and/or a reduction of serum albumin. Level of evidence III, evidence obtained from well-designed cohort or case-control analytic studies

Risk and protective factors of quality of life for children with autism spectrum disorder and their families during the COVID-19 lockdown. An Italian study.

BACKGROUND: The lockdown due to the COVID-19 pandemic has been a difficult period for children with Autism Spectrum Disorder (ASD), and their families. AIMS: The aim of this study was to investigate the predictors of the quality of life (QoL) of children with ASD and their parents throughout the first lockdown, providing a snapshot of the impact of the pandemic on these families life. METHOD AND PROCEDURES: A cohort of 243 parents of children with ASD (2-15 years old) completed an original online survey regarding the modification of ASD cores symptoms during lockdown, the type of interventions they had done before and during lockdown and the activities performed by the child. Respondents filled the PedsQL for themselves and their children. OUTCOME AND RESULTS: The data obtained show a worsening of specific ASD core symptoms during lockdown and their role in predicting parents and children's QoL. Furthermore, protective factors for a better children's QoL as the Telehealth intervention, and some activities done at home during the lockdown as physical activity and play with parents are identified. CONCLUSIONS: This study identifies the QoL's risk and protective factors for children with ASD and their families. Furthermore, reveals the fundamental role of the parents as children's QoL protective factor, suggesting a higher collaboration between families and health care providers, whilst potentially improving families and children's QoL.

Introducing the COVID-19 crisis Special Education Needs Coping Survey (preprint)

Individuals with special education needs have been particularly affected by the COVID-19 pandemic as they have been shown to be at high risk of losing medical and institutional support at a time when people are being asked to stay isolated, suffering increased anxiety and depression as a consequence. Their families have often found themselves under tremendous pressure to provide support, engendering financial hardship, and physical and emotional strains. In such times, it is vital that international collaborations assess the impact on the individuals and their families, affording the opportunity to make national and international comparisons of how people have coped and what needs to be done to optimize the measures taken by families, associations and governments. This paper introduces one such collaboration.