Effect of COVID-19 on frequency and severity of eating disorder admissions in a specialized pediatric inpatient unit
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Background
During the COVID-19 pandemic, youth experienced disruptions in their social development due to social distancing mandates. Research evaluating effects of isolation on adolescent mental health and eating disorders demonstrated increased ED visits during COVID. The goal of this study was to examine the effect of the COVID-19 pandemic on the number of eating disorder admissions at a large pediatric inpatient eating disorder unit and on illness severity.
Methods
We conducted a retrospective chart review of patients admitted to a pediatric inpatient eating disorder unit from January 2019 through December 2021. Differences in number of admissions and patient characteristics were compared before and after the start of the COVID-19 stay-at-home mandate (i.e., “outbreak”). Interrupted time series analysis compared monthly admission trends pre- and post-outbreak. Logistic and linear regression models were created to evaluate differences in severity.
Results
There were 143 patients admitted pre-outbreak and 314 patients admitted post-outbreak (84% female, 26.3% publicly insured, median age 15 years). There was a significant increase in the mean number of admissions per month post-outbreak (10.21, [SD 3.36] vs. 14.27 [SD 3.31], p < 0.01). Trends in admissions per month were stable prior to the COVID-19 outbreak (β 1 = -0.38, p = 0.07) and increased after the start of the outbreak (β 3 = 0.63, p < 0.01). Patients pre-outbreak had lower mean systolic blood pressures than post-outbreak (β = -1.90 [SE 0.82], p = 0.02). The odds of hypophosphatemia were lower post-outbreak (OR 0.42 [95% CI 0.21–0.81]).
Conclusions
Clinical characteristics on admission were less severe post-outbreak. Closures of outpatient treatment programs may have led to lower acuity patients being hospitalized. Preserving access to robust outpatient eating disorder treatment may prevent this phenomenon during future public health crises.
