Miniati Mario, Marzetti Francesca, Palagini Laura, Marazziti Donatella, Orrù Graziella, Conversano Ciro, Gemignani Angelo
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy.
Front Psychol. 2021 Sep 29;12:663376. doi: 10.3389/fpsyg.2021.663376. eCollection 2021.
Several data suggest that coronavirus disease 2019 (COVID-19) pandemic may exacerbate or trigger eating disorders (EDs). The aim of this paper was to summarize current literature studies on COVID pandemic and EDs. Literature search, study selection, methods, and quality evaluation were performed according to the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. A systematic search allowed the initial selection of 172 papers; 21 (12.2%) papers were eligible and included in the review. In selected studies, a total number of 29,108 subjects were enrolled (range: 10-11,391; mean/SD: 1,386 ± 2,800), 6,216 were men (21.4%), 22,703 were women (77.9%), and 189 (0.7%) were gender fluid or not declared. The mean age/SD of subjects was 30.2 ± 7.7. About 12 studies (57.1%) were online surveys, 4 (19.0%) were retrospective studies, 2 (9.5%) were qualitative studies, 2 (9.5%) were longitudinal cohort studies, and 1 was a social media survey (4.8%). Their analysis revealed five main findings: (1) changes in the routines of physical activities were related to the worsening of preoccupation on weight/body shape; (2) food access limitation during pandemic represented the risk factors for both triggering and exacerbating EDs; (3) restriction in healthcare facilities contributed to increase anxiety levels and to modify treatment compliance; (4) social isolation was related to the exacerbation of symptoms in patients with EDs who are home-confined with family members; and (5) conflicts and difficulties in relationships with "no way out" were the maintenance factors for ED symptoms, especially in adolescents and young adults. The COVID-19 pandemic had a negative impact on EDs that might be triggered by the exceptional conditions derived from COVID-19-related stress in predisposed subjects. Patients who were already affected by EDs experienced the worsening of their clinical conditions and related quality of life (QoL).
多项数据表明，2019冠状病毒病（COVID-19）大流行可能会加剧或引发饮食失调（EDs）。本文旨在总结当前关于COVID大流行与饮食失调的文献研究。文献检索、研究选择、方法及质量评估均按照系统评价与荟萃分析的首选报告项目（PRISMA）指南进行。系统检索初步筛选出172篇论文；21篇（12.2%）论文符合条件并纳入综述。在所选研究中，共纳入29108名受试者（范围：10 - 11391；均值/标准差：1386±2800），其中男性6216名（21.4%），女性22703名（77.9%），189名（0.7%）性别流动或未声明。受试者的平均年龄/标准差为30.2±7.7。约12项研究（57.1%）为在线调查，4项（19.0%）为回顾性研究，2项（9.5%）为定性研究，2项（9.5%）为纵向队列研究，1项为社交媒体调查（4.8%）。对这些研究的分析揭示了五个主要发现：（1）体育活动日常安排的改变与对体重/体型关注度的增加有关；（2）大流行期间食物获取受限是引发和加剧饮食失调的危险因素；（3）医疗设施的限制导致焦虑水平上升并影响治疗依从性；（4）社交隔离与居家与家人隔离的饮食失调患者症状加重有关；（5）与“无路可走”的人际关系中的冲突和困难是饮食失调症状的维持因素，尤其是在青少年和年轻人中。COVID-19大流行对饮食失调产生了负面影响，这可能是由易感人群中与COVID-19相关压力导致的特殊情况引发的。已经患有饮食失调的患者临床状况及其相关生活质量（QoL）恶化。
