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Emotional, hyperactivity and inattention problems in adolescents with immunocompromising chronic diseases during the COVID-19 pandemic
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Campos, Reinan T.
; Lindoso, Livia
; Sousa, Renan A. de
; Helito, Alberto C.
; Ihara, Bianca P.
; Strabelli, Claudia A.A.
; Paradelas, Levi M.V.
; Carneiro, Beatriz O.L.
; Cardoso, Maria Paula R.
; Souza, Jean Paulo V. de
; Freire, Marianna R. de M.
; Astley, Camilla
; Laurentino, Moisés F.
; Buscatti, Izabel M.
; Kozu, Katia
; Aikawa, Nadia E.
; Sallum, Adriana M.E.
; Ferreira, Juliana CO.
; Simon, Juliana R.
; Viana, Vivianne S.L.
; Queiroz, Ligia B.
; Gualano, Bruno
; Roschel, Hamilton
; Pereira, Rosa Maria R.
; Toma, Ricardo K.
; Watanabe, Andréia
; Grangeiro, Patricia M.
; Casella, Caio B.
; Farhat, Sylvia C.
; Polanczyk, Guilherme V.
; Campos, Lucia Maria A.
; Silva, Clovis A.
.
Abstract Objective: To assess factors associated with emotional changes and Hyperactivity/Inattention (HI) motivated by COVID-19 quarantine in adolescents with immunocompromising diseases. Methods: A cross-sectional study included 343 adolescents with immunocompromising diseases and 108 healthy adolescents. Online questionnaires were answered including socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and validated surveys: Strengths and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0). Results: The frequencies of abnormal emotional SDQ scores from adolescents with chronic diseases were similar to those of healthy subjects (110/343 [32%] vs. 38/108 [35%], p = 0.548), as well as abnormal hyperactivity/inattention SDQ scores (79/343 [23%] vs. 29/108 [27%], p = 0.417). Logistic regression analysis of independent variables associated with abnormal emotional scores from adolescents with chronic diseases showed: female sex (Odds Ratio [OR = 3.76]; 95% Confidence Interval (95% CI) 2.00–7.05; p < 0.001), poor sleep quality (OR = 2.05; 95% CI 1.08–3.88; p = 0.028) and intrafamilial violence during pandemic (OR = 2.17; 95% CI 1.12–4.19; p = 0.021) as independently associated with abnormal emotional scores, whereas total PedsQL score was inversely associated with abnormal emotional scores (OR = 0.95; 95% CI 0.93–0.96; p < 0.0001). Logistic regression analysis associated with abnormal HI scores from patients evidenced that total PedsQL score (OR = 0.97; 95% CI 0.95–0.99; p = 0.010], changes in medical appointments during the pandemic (OR = 0.39; 95% CI 0.19–0.79; p = 0.021), and reliable COVID-19 information (OR = 0.35; 95% CI 0.16–0.77; p = 0.026) remained inversely associated with abnormal HI scores. Conclusion: The present study showed emotional and HI disturbances in adolescents with chronic immunosuppressive diseases during the COVID-19 pandemic. It reinforces the need to promptly implement a longitudinal program to protect the mental health of adolescents with and without chronic illnesses during future pandemics.
2.
Seroconversion in asymptomatic COVID-19 pediatric patients with rheumatic diseases of one tertiary referral hospital
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Simon, Juliana R.
; Pereira, Maria F.B.
; Marques, Heloisa H.
; Elias, Adriana M.
; Sakita, Neusa K.
; Ferreira, Juliana C.O.A.
; Precioso, Alexander Roberto
; Grisi, Sandra J.F.E.
; Ferrer, Ana Paula S.
; Bain, Vera
; Silva, Clovis A.
; Campos, Lúcia M.A.
.
Abstract Objectives: To evaluate seroconverted asymptomatic COVID-19 in pediatric Autoimmune Rheumatic Diseases (ARDs) patients and to identify the risk factors related to contagion. Methods: A cross-sectional study was conducted in March 2021, before vaccination of children and adolescents in Brazil, including 77 pediatric ARDs patients, followed at a tertiary hospital and 45 healthy controls, all of them without a previous diagnosis of COVID-19. Data was obtained by a questionnaire with demographic data, symptoms compatible with COVID-19 over the previous year, and contact with people with confirmed COVID-19. Patient’s medical records were reviewed to access data regarding disease and current medications. A qualitative immunochromatographic SARS-CoV-2 test was performed on all participants. Results: Patients and controls were similar in terms of female gender (70.1% vs. 57.8%, p = 0.173), age (14 vs. 13 years, p = 0.269) and SARS-CoV-2 positive serology (22% vs. 15.5%, p = 0.481). 80.5% of rheumatic patients were in use of immunosuppressive drugs: 27.3% of them used corticosteroids (33.3% in high doses), and 7.8% on immunobiologicals. No statistical differences were found between positive (n = 17) and negative serology (n = 60) patients regarding demographic/socioeconomic data, contact with people with confirmed COVID-19, use and number of immunosuppressive drugs, use and dose of corticosteroids, use of hydroxychloroquine and immunobiological drugs (p > 0.05). Conclusions: Pediatric rheumatic disease patients were infected at the same rate as healthy ones. Neither the underlying pathology nor its immunosuppressive treatment seemed to interfere with contagion risk.
3.
Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine
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Helito, Alberto C.
; Lindoso, Livia
; Sieczkowska, Sofia M.
; Astley, Camilla
; Queiroz, Ligia B.
; Rose, Natalia
; Santos, Claudia Renata P.
; Bolzan, Thalis
; Peralta, Rita María I.A.
; Franco, Ruth R.
; Cominato, Louise
; Pereira, Rosa Maria R.
; Tannuri, Uenis
; Campos, Lucia Maria A.
; Lourenço, Benito
; Toma, Ricardo K.
; Medeiros, Karina
; Watanabe, Andréia
; Grangeiro, Patricia Moreno
; Farhat, Sylvia C.
; Casella, Caio B.
; Polanczyk, Guilherme V.
; Gualano, Bruno
; Silva, Clovis A.
; Sallum, Adriana M. E.
; Iraha, Amanda Y.
; Ihara, Bianca P.
; Mazzolani, Bruna C.
; Martinez, Claudia A.
; Strabelli, Claudia A. A.
; Fonseca, Claudia B.
; Lima, Dandara C. C.
; Setoue, Debora N. D.
; Roz, Deborah F. P.
; Smaira, Fabiana I.
; Roschel, Hamilton
; Miyatani, Helena T.
; Marques, Isabela G.
; Oba, Jane
; Ferreira, Juliana C. O.
; Simon, Juliana R.
; Kozu, Katia
; Saccani, Ligia P.
; Martiniano, Lorena V. M.
; Miranda, Luana C. A.
; Silva, Luiz E. V.
; Laurentino, Moisés F.
; Aikawa, Nadia E.
; Sakita, Neusa K.
; Tanigava, Nicolas Y.
; Pereira, Paulo R. A.
; Palmeira, Patrícia
; Angelo, Simone S.
; Lavorato, Sofia S. M.
; Bernardes, Tamires M.
; Franco, Tathiane C.
; Viana, Vivianne S. L.
; Barros, Vera P. M. F. R.
; Zheng, Yingying
.
OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p<0.001). CONCLUSION: Self-reported increases in screen time and intrafamilial violence report impacted sleep quality in both healthy adolescents and those with chronic conditions. Decreased health-related quality of life was observed in adolescents with poor sleep quality.
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