Hospitalization patterns for adolescents with eating disorders during COVID-19.

PURPOSE

The purpose of this study was to examine differences in clinical characteristics and hospital length of stay (LOS) for adolescents with eating disorders (EDs) requiring medical stabilization during the pre-COVID-19 and COVID-19 time periods.

METHODS

Medical record data were abstracted for patients with EDs hospitalized for medical stabilization between 1/1/2019-2/29/2020 (pre-COVID-19) and 3/1/2020-12/31/2021 (during COVID-19). Patient demographics, clinical characteristics and LOS were compared between COVID-19 eras. Patients were categorized as boarding if they remained hospitalized ≥ 1 day after medical stabilization. Multivariate negative binomial linear regression models were performed to determine incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for factors related to increased LOS.

RESULTS

Of the 467 admissions during this study, 120 were pre-COVID-19 and 347 were during COVID-19. Monthly admissions for EDs were higher during COVID-19 versus pre-COVID-19 (15.8 vs. 8.6, p = 0.001). On multivariate analysis, factors associated with increased LOS included admission during COVID-19 (IRR 1.27, 95% CI 1.15-1.40), p = 0.001), boarding (IRR 1.77, 95% CI 1.63-1.93, p = 0.001), public insurance (IRR 1.12, 95% CI 1.01-1.23, p = 0.032), nasogastric tube usage (IRR 1.62, 95% CI 1.48-1.76, p = 0.001), heart rate < 40 beats per minute (IRR 1.21, 95% CI 1.11-1.33, p = 0.001) and abnormal electrocardiogram (IRR 1.25, 95% CI 1.14-1.37, p = 0.001).

CONCLUSION

In addition to clinical factors, we found that admission during COVID-19, boarding, and public insurance were associated with increased LOS among patients with EDs. There is a need for greater availability of ED treatment centers to care for patients with EDs after medical stabilization.