Pediatric Allergy and Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India, 160012.
J Clin Immunol. 2023 Oct;43(7):1483-1495. doi: 10.1007/s10875-023-01524-5. Epub 2023 Jun 6.
Day-to-day clinical management of patients with inborn errors of immunity, including chronic granulomatous disease (CGD), has been affected by the coronavirus disease-2019 (COVID-19) pandemic. There is a dearth of information on impact of this pandemic on clinical care of children with CGD and psychological profile of the caretakers. Among the 101 patients with CGD followed up in our center, 5 children developed infection/complications associated with COVID-19. Four of these children had a mild clinical course, while 1 child developed features of multisystem inflammatory syndrome in children (MISC) requiring intravenous glucocorticoids. Parents and caretakers of CGD patients (n = 21) and 21 healthy adults with similar ages and genders were also evaluated on the following scales and questionnaires: COVID-19 Fear Scale (FCV 19S), Impact of Event Scale (IES-R), Depression, Anxiety, and Stress Scale (DASS 21), Preventive COVID-19 Behavior Scale (PCV 19BS), and a "COVID-19 Psychological wellbeing questionnaire." Median age of the parents/caregivers was 41.76 years (range: 28-60 years). Male:female ratio was 2:1. In the study group, 71.4% had higher IES scores compared to 14.3% in controls. The caregivers had a high prevalence of stress, anxiety, avoidance behavior, and depression compared to controls (p < 0.001). Children with CGD have had predominantly mild infection with COVID-19; however, caregivers/parents of these children were at risk of developing psychological distress. The COVID-19 pandemic has brought to light the importance of patients' and caretakers' mental health which needs periodic assessment and appropriate interventions.
先天性免疫缺陷患者（包括慢性肉芽肿病[CGD]）的日常临床管理受到了 2019 年冠状病毒病（COVID-19）大流行的影响。关于这次大流行对 CGD 患儿临床护理和照顾者心理状况的影响，信息匮乏。在我们中心随访的 101 例 CGD 患者中，有 5 例患儿发生了与 COVID-19 相关的感染/并发症。这 5 例患儿中，4 例患儿的临床病程较轻，而 1 例患儿出现了儿童多系统炎症综合征（MISC）的特征，需要静脉注射糖皮质激素。还对 CGD 患者的父母/照顾者（n=21）和 21 名年龄和性别相似的健康成年人进行了以下量表和问卷评估：COVID-19 恐惧量表（FCV 19S）、事件影响量表修订版（IES-R）、抑郁、焦虑和压力量表（DASS 21）、预防 COVID-19 行为量表（PCV 19BS）和“COVID-19 心理健康问卷”。父母/照顾者的中位年龄为 41.76 岁（范围：28-60 岁），男女比例为 2:1。在研究组中，71.4%的患者 IES 评分较高，而对照组为 14.3%。与对照组相比，照顾者的压力、焦虑、回避行为和抑郁发生率较高（p<0.001）。CGD 患儿感染 COVID-19 主要为轻症；然而，这些患儿的照顾者/父母存在发生心理困扰的风险。COVID-19 大流行凸显了患者和照顾者心理健康的重要性，需要定期评估和适当干预。
