Chan Melvin, Mokiao Reya, Wilson Amy C, Pottanat Neha, Hingorani Sangeeta, Starr Michelle
Indiana University School of Medicine.
Seattle Children's Hospital.
Res Sq. 2022 Mar 30:rs.3.rs-910466. doi: 10.21203/rs.3.rs-910466/v1.
Background Food insecurity, an important social determinant of health among children, has become more common during the COVID-19 pandemic. Children with chronic diseases including end-stage kidney disease (ESKD) are at higher risk of food insecurity due to their complex care needs, medication burden, and dietary restrictions. No data exists describing food insecurity prevalence in pediatric ESKD patients during the COVID-19 pandemic. Methods Food insecurity was assessed among families of children (age 0-18 years) with ESKD on chronic dialysis at two pediatric academic medical centers. Families were screened in April 2020 using the Hunger Vital Sign, a validated 2-question screening tool. We assessed impact of COVID-19 on food insecurity. We compared serum phosphorus "pre-COVID" (January/February 2020) to "during COVID" (April/May 2020). Results A total of 29 families enrolled in this study. 62% (18/29) of children with ESKD lived in food insecure households, and of those, 72% (13/18) reported that COVID-19 had worsened their food insecurity status. During the COVID-19 pandemic, food insecure patients experienced greater rise in their serum phosphorus levels ( =0.03) and decreased likelihood of having adequate phosphorus control ( =0.03). Conclusion Food insecurity was common among children with ESKD on chronic dialysis during the COVID-19 pandemic. Children with food insecurity had a greater increase in their phosphorus levels during the pandemic than did food secure children. Further exploration into how food resources such as an onsite food pantry impacts food insecurity and phosphorus control in children with ESKD is essential.
粮食不安全是儿童健康的一个重要社会决定因素，在新冠疫情期间变得更为普遍。患有包括终末期肾病（ESKD）在内的慢性病的儿童，由于其复杂的护理需求、药物负担和饮食限制，面临粮食不安全的风险更高。目前尚无关于新冠疫情期间儿科ESKD患者粮食不安全患病率的数据。方法：在两家儿科学术医疗中心，对接受慢性透析的ESKD儿童（0至18岁）家庭进行粮食不安全评估。2020年4月使用经过验证的两问题筛查工具“饥饿生命体征”对家庭进行筛查。我们评估了新冠疫情对粮食不安全的影响。我们比较了“新冠疫情前”（2020年1月/2月）和“新冠疫情期间”（2020年4月/5月）的血清磷水平。结果：共有29个家庭参与了本研究。62%（18/29）的ESKD儿童生活在粮食不安全家庭，其中72%（13/18）报告称新冠疫情使他们的粮食不安全状况恶化。在新冠疫情期间，粮食不安全的患者血清磷水平升高幅度更大（P = 0.03），且磷控制达标的可能性降低（P = 0.03）。结论：在新冠疫情期间，接受慢性透析的ESKD儿童中粮食不安全情况很常见。与粮食安全的儿童相比，粮食不安全的儿童在疫情期间磷水平升高幅度更大。进一步探究诸如现场食品储藏室等食物资源如何影响ESKD儿童的粮食不安全和磷控制至关重要。
