McVoy Molly, Hung Rina, Bransteter Irina, Perez Jaime A, Segall Tracy L, Surdam Jessica O, Miller David W, Dusek Jeffrey A, Sajatovic Martha
Case Western Reserve University School of Medicine, Cleveland, Ohio.
University Hospitals Cleveland Medical Center, Cleveland, Ohio.
JAACAP Open. 2023 Dec 26;2(3):180-187. doi: 10.1016/j.jaacop.2023.12.004. eCollection 2024 Sep.
Stressors from the COVID-19 pandemic and limited availability of mental health care services have negatively impacted youth mental health in a significant way. In the first year of the pandemic, global prevalence of anxiety and depression increased by roughly 25% in pediatric populations. While the general trend is clear, this research aimed to explore the added mental health burden of acute COVID-19 on pediatric patients with chronic conditions and describe the differences in mental health outcomes between pediatric patients with 2 common chronic conditions (asthma and diabetes) to better understand specific factors that may increase susceptibility to mental health concerns.
Using the TriNetX database, data were extracted for all pediatric patients (aged 5-17 years) with a positive SARS-CoV-2 infection (COVID-19) within a 1-year time frame (April 7, 2021, to April 6, 2022). These patients were divided into 4 cohorts based on the presence of chronic conditions before COVID-19 infection: diabetes (n = 1,587), asthma (n = 13,217), diabetes plus asthma (n = 626), and neither diabetes nor asthma (n = 104,427). For all cohorts, patients with other chronic illness and previous mental health diagnoses were excluded using relevant codes. After matching for demographics, comorbid conditions, and body mass index, odds ratios (ORs) of the following outcomes were compared between cohorts after 6 months: new psychiatric diagnosis using relevant codes, hospitalization within 1 week, and mortality.
After matching, there were statistically significant differences in outcomes between patients with chronic illness and healthy controls after 6 months. Compared with healthy controls, the asthma cohort OR of developing a new psychiatric diagnosis was 1.4 (95% CI 1.15-1.71, < .001), and the diabetes cohort OR was 1.81 (95% CI 1.11-2.94, = .015). The new psychiatric diagnosis OR of the asthma cohort compared with the diabetes cohort was 0.62 (95% CI 0.39-0.99, = .045), suggesting that patients in the diabetes cohort were particularly susceptible to additional mental health diagnoses after an acute COVID-19 infection.
Compared with healthy controls, pediatric patients with asthma and pediatric patients with diabetes experienced increased odds of developing a new psychiatric diagnosis after an acute COVID-19 infection.
2019年冠状病毒病（COVID-19）大流行带来的压力源以及心理健康护理服务的有限可及性对青少年心理健康产生了重大负面影响。在大流行的第一年，儿科人群中焦虑和抑郁的全球患病率大约增加了25%。虽然总体趋势很明显，但本研究旨在探讨急性COVID-19给患有慢性病的儿科患者增加的心理健康负担，并描述患有两种常见慢性病（哮喘和糖尿病）的儿科患者在心理健康结果方面的差异，以更好地了解可能增加心理健康问题易感性的具体因素。
使用TriNetX数据库，提取了在1年时间范围内（2021年4月7日至2022年4月6日）所有SARS-CoV-2感染呈阳性（COVID-19）的儿科患者（5至17岁）的数据。这些患者根据COVID-19感染前是否存在慢性病分为4组：糖尿病组（n = 1587）、哮喘组（n = 13217）、糖尿病合并哮喘组（n = 626）以及既无糖尿病也无哮喘组（n = 104427）。对于所有组，使用相关编码排除患有其他慢性病和既往有心理健康诊断的患者。在对人口统计学、合并症和体重指数进行匹配后，比较了6个月后各组之间以下结局的比值比（OR）：使用相关编码的新发精神疾病诊断、1周内住院和死亡率。
匹配后，6个月后慢性病患者与健康对照者在结局方面存在统计学显著差异。与健康对照者相比，哮喘组新发精神疾病诊断的OR为1.4（95%可信区间1.15 - 1.71，P <.001），糖尿病组的OR为1.81（95%可信区间1.11 - 2.94，P = 0.015）。哮喘组与糖尿病组相比，新发精神疾病诊断的OR为0.62（9
