Department of Dietetics and Speech & Language Therapy, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Nutrition & Dietetics, Faculty of Health and Well Being, University of Winchester, Winchester, UK.
J Hum Nutr Diet. 2021 Aug;34(4):656-659. doi: 10.1111/jhn.12862. Epub 2021 Feb 9.
The COVID-19 pandemic has had wide-reaching primary and secondary health implications. The UK government implemented a national lockdown to slow the rate of infection at the end of March 2020, lasting until early summer 2020. The results from a UK nationwide survey suggest the majority of inflammatory bowel disease patients were followed up using technology-enabled care services (TECS) during this time. We therefore aimed to explore the impact of the pandemic on nutritional status of children with inflammatory bowel disease, focusing on the effect of national lockdown from March to early summer 2020.
A retrospective study was conducted. All patients with a diagnosis of inflammatory bowel disease, aged <18 years, and under the care of Southampton Children's Hospital were eligible for inclusion. Those patients who attended an outpatient appointment during time period 1 (November 2019 to February 2020), and following the period of national lockdown, time period 2 (July to November 2020), were included in the analysis.
In total, 116 patients had paired measures. Using the World Health Organization criteria of nutritional status, 19% (n = 22/116) were mildly malnourished with a body mass index Z score (BMIZ) < -1. In this group, the mean BMIZ was -1.3 ± 0.9 at time point 1 versus -1.9 ± 0.9 at time point 2 (p = 0.03). The mean BMIZ score of those children who were overweight at time point 1 was 1.2 ± 1.2 versus 1.6 ± 1.4 at time point 2 (p = 0.2) During the period of lockdown, 27% of malnourished children (n = 6/22), 2% of normally nourished children (BMIZ > -1 to < 1) (n = 1/51) (p ≤ 0.0001) and none of the overweight children (BMIZ > 1) (n = 0/43) children (p ≤ 0.0001) had a TECS nutrition review.
Dietetic reviews were severely restricted during the first national lockdown. Patients with low BMIZ prior to lockdown became more malnourished. During the ongoing pandemic, it is important to identify those children with nutrition risk, focusing support on this group of children.
COVID-19 大流行对初级和二级卫生系统产生了广泛影响。英国政府于 2020 年 3 月底实施了全国封锁措施，以减缓感染速度，一直持续到 2020 年初夏。来自英国全国范围的一项调查结果表明，在此期间，大多数炎症性肠病患者都通过使用技术支持的护理服务（TECS）进行了随访。因此，我们旨在探讨大流行对炎症性肠病儿童营养状况的影响，重点关注 2020 年 3 月至初夏期间的全国封锁的影响。
进行了一项回顾性研究。所有年龄<18 岁，在南安普顿儿童医院接受治疗的炎症性肠病患者均符合入选条件。那些在时间 1（2019 年 11 月至 2020 年 2 月）期间就诊过并在全国封锁后的时间 2（2020 年 7 月至 11 月）期间就诊过的患者被纳入分析。
共有 116 名患者进行了配对测量。根据世界卫生组织的营养状况标准，19%（n=22/116）有轻度营养不良，身体质量指数 Z 评分（BMIZ）<-1。在这组中，时间点 1 的平均 BMIZ 为-1.3±0.9，时间点 2 为-1.9±0.9（p=0.03）。在时间点 1 超重的儿童中，平均 BMIZ 评分为 1.2±1.2，而时间点 2 为 1.6±1.4（p=0.2）。在封锁期间，27%的营养不良儿童（n=6/22）、2%的营养正常儿童（BMIZ>-1 至<1）（n=1/51）（p≤0.0001）和超重儿童（BMIZ>1）（n=0/43）（p≤0.0001）都没有进行 TECS 营养评估。
在第一次全国封锁期间，饮食评估受到严重限制。在封锁前 BMIZ 较低的患者变得更加营养不良。在当前的大流行期间，重要的是要确定有营养风险的儿童，并将支持重点放在这群儿童身上。
