Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity: Longitudinal study update.

Objective: A previous report from our group identified directionally unfavorable dietary and lifestyle behavior trends in longitudinally monitored children and adolescents with obesity early in the COVID-19 pandemic lockdown. The current study aimed at extending these previous observations in youths with obesity on the dietary and lifestyle behavioral consequences of the extended COVID-19 lockdown in Verona, Italy. Methods: The sample included 32 children and adolescents with obesity participating in the longitudinal OBELIX study. Diet and lifestyle information were collected pre-pandemic, 3 weeks into the national lockdown, and 9 months later when home confinement continued to be mandatory. Changes in outcomes over the study time points were evaluated for significance using repeated-measures ANOVA and post-hoc pairwise t-tests with Bonferroni corrections. Results: As previously reported, meals/day, fried potato intake, and red meat ingestion increased significantly (p < 0.001) during the initial lockdown. Sleep time and screen time increased and sports participation decreased significantly (p < 0.001) during the initial lockdown. These changes in health behaviors remained significantly different from baseline at the second lockdown assessment, with the exception sleep time returned to baseline levels. Conclusions: Unfavorable diet and lifestyle behavioral changes in response to the initial COVID-19 lockdown in children and adolescents with obesity have largely been sustained over the course of the pandemic. There is an urgent need to intervene on these behaviors to prevent further deleterious effects on long-term child health; access to weight management care is critically important for these children. In addition to intervening on these behaviors, our findings should help to inform ongoing lockdown policies.

The need of an updated culture of "occupational" atopic hand dermatitis in children at the time of COVID-19.

During the COVID-19 outbreak, handwashing emerged as an essential tool to prevent the spread of SARS-CoV-2 virus. It can put into practice using warm water and soap or, if not available, alcohol-based hand sanitizers (ABHS). Anyway, the use of warm water and soap is not always possible. On the contrary, ABHS are frequently used for their versatility, but can represent a risk factor for atopic dermatitis exacerbations in the pediatric age. At the same time, the Italian Ministry of Health established a school regulation, asking the students to periodically disinfect hands with sanitizing gel, or soap and water, especially before entering classrooms and laboratories, immediately after contact with everyday objects, after using the toilet, after throwing away the handkerchief and before and after eating. No rules have been personalized in this statement for children affected by atopic dermatitis attending the school. Based on this observation, we reported two case reports, involving children with a known diagnosis of atopic dermatitis, who attended our Pediatric Allergy Unit in Mantua, Italy. They experienced a worsening of symptoms related to AD on their hands in the last year for an intensive handwashing with ABHS before entering all classrooms and laboratories every day at school. Avoiding ABHS at school and washing their hands with a non-alcohol and additives soap and water solved their problem and brought their atopic dermatitis back to good control. So, it seems appropriate to consider ABHS as a "school trigger" and the low-controlled atopic dermatitis of these two patients as an "occupational dermatitis". An adequate pediatric culture of atopic dermatitis at the time of COVID 19 is needed.

The potential role of zinc, magnesium and selenium against COVID-19: a pragmatic review

INTRODUCTION: Several studies have analyzed the role of antioxidant minerals as positive modulators of the immune system in facing viral infections. We discuss their possible protective role in Sars-Cov 2 infection selecting minerals for which literature provides most evidences, such as zinc (Zn), magnesium (Mg), and selenium (Se).DISCUSSION: All these minerals have a role in modulating antiviral and antibacterial immunity and to regulate the inflammatory response. Their deficiency is associated with a higher prevalence of respiratory tract infections andendothelial dysfunction. These features are related to COVID-19 pathophysiology.CONCLUSIONS: It seems that an optimal micronutrient status in terms of Zn, Mg and Se, is able to effectively strengthen the immune system during the COVID-19 infection. Anyway, further studies are necessary. [ FROM AUTHOR] Copyright of Child & Adolescent Obesity (2574254X) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Childhood obesity and SARS-CoV2: dangerous liaisons

BACKGROUND: Nowadays obesity and CoronaVIrus Disease-19 (COVID-19), for some extent, represent two major public health problems worldwide. These diseases, albeit extremely different, have a pandemic pattern of diffusion and have enormous direct and indirect effects both on health and lifestyle. AIM: Aim of our narrative review was to analyze in the pediatric population, the relationship between these two diseases using a holistic approach. MATERIALS AND METHODS: We performed a quasi-review with a systematic literature search through the Cochrane Library and Medline/PubMed databases from 1 January 2013 to 1 October 2020. Two authors independently extracted data using predefined data fields and rated study quality. Two main key words were considered, obesity and COVID-19, pointing a particular focus on pediatric patients. We also analysed the relationship between obesity and COVID-19 in adults for comparison. CONCLUSION: Evidences showed that during quarantine due to COVID-19, children and adolescents were physically less active, have much longer screen time exposure, sleep patterns disturbances, and less favorable diets, possibly resulting in weight gain and in a loss of cardio-respiratory fitness. Such negative effects on health are likely to be much worse in subjects that are overweight or have obesity. Moreover, stressors emerging from the prolonged national lock-down around the world and from social distancing could have even more problematic and enduring effects considering that obese children are more susceptible to psychiatric disorders. Obesity represents also a risk factor for COVID-19 severity in younger adults but at the moment in pediatric population we have very limited data. Public health interventions are urgently called in order to promote an active lifestyle and engagement in social activities in children and possibly to mitigate the adverse impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in pediatric subjects that are overweight or have obesity. [ FROM AUTHOR] Copyright of Child & Adolescent Obesity (2574254X) is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The "Stay at home" COVID-19 lockdown restriction may have prevented asthma exacerbations in children affected by pollen allergy: a single center experience.

BACKGROUND: The "Stay at home" COVID-19 lockdown restriction represented a "real-life experiment" of pollen avoidance for children affected by pollen allergy. METHODS: The study retrospectively analyzed all children with a known diagnosis of pollen-allergy asthma who attended the emergency department (ED) for an asthma exacerbations (AE) in the town of Mantua and its province in the period March 09-May 03 of the years 2018, 2019 and 2020. RESULTS: In 2020, 4 (0.7%) children with a known diagnosis of pollen-allergy accessed the ED for an AE. Pediatric access was a total of 20 (0.5%) and 12 (0.3%) in 2018 and 2019 in the same period. The rate of hospitalization was 0 in 2020 versus 3 (15%) and 1 (8.3%) in 2018 and 2019, respectively. CONCLUSIONS: The inevitable pollen avoidance during COVID-19 lockdown may have prevented asthma exacerbations in children affected by pollen allergy.

Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study.

OBJECTIVE: The aim of this study was to test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the coronavirus disease 2019 pandemic, will display unfavorable trends in lifestyle behaviors. METHODS: The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors was collected at baseline and 3 weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using paired t tests. RESULTS: There were no changes in reported vegetable intake; fruit intake increased (P = 0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (P value range, 0.005 to < 0.001). Time spent in sports activities decreased by 2.30 (SD 4.60) h/wk (P = 0.003), and sleep time increased by 0.65 (SD 1.29) h/d (P = 0.003). Screen time increased by 4.85 (SD 2.40) h/d (P < 0.001). CONCLUSIONS: Recognizing these adverse collateral effects of the coronavirus disease 2019 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child's or adolescent's adult adiposity level.