Impact of Coronavirus disease 2019 pandemic in children with functional abdominal pain disorders: Data from long-term follow-up

Massimo Martinelli; Caterina Strisciuglio; Peter Lu; Michal Rozenfeld Bar Lev; Beate Beinvogl; Carlo Di Lorenzo; Sabrina Cenni; Samuel Nurko; Haley Pearlstein; Rachel Rosen; Raanan Shamir; Annamaria Staiano

doi:10.1002/jpn3.12225

Impact of Coronavirus disease 2019 pandemic in children with functional abdominal pain disorders: Data from long-term follow-up

J Pediatr Gastroenterol Nutr. 2024 May 2. doi: 10.1002/jpn3.12225. Online ahead of print.

Affiliations

¹ Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy.
² Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Napoli, Italy.
³ Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA.
⁴ Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Faculty of Medicine, Tel Aviv University, Petach Tikvah, Israel.
⁵ Boston Children's Hospital, Harvard medical School, Boston, Massachusetts, USA.

PMID: 38698661
DOI: 10.1002/jpn3.12225

Abstract

Objective: We aimed to compare symptom frequency and severity in children with functional abdominal pain disorders (FAPDs) and to evaluate anxiety, quality of life (QoL) and global health during Coronavirus disease 2019 (COVID-19) related quarantine and after 17 months.

Methods: Children diagnosed with FAPDs between October 2019 and February 2020 at 5 different centers were enrolled and prospectively interviewed during the COVID-19 quarantine and 17 months later when schools, hospital services, and routine activities had re-opened to the public. The patients were asked to complete the Rome IV questionnaire, the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) Generic Core Scale, the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and global health questionnaires. Data about COVID-19 infection and its clinical outcome were also collected.

Results: Ninety-nine out of 180 (55%) children completed the follow-up. The number of patients reporting a worsening of their symptoms was significantly higher at follow-up when compared to the quarantine period (24/99 [24.2%] vs. 12/99 [12.1%]; p = 0.04). The PedsQL 4.0 subtotal score at follow-up significantly decreased at 17 months of follow-up (65.57 [0-100]) when compared to the quarantine (71 [0-100], p = 0.03). Emotional functioning was the most significantly reduced (Follow-up: 64.7 [0-100] vs. Quarantine: 75 [0-100]; p = 0.006). We did not identify significant differences in symptoms and QoL between COVID-19 infected children and the remaining cohort at the two time points.

Conclusions: An improvement of symptoms and QoL was observed during the quarantine, followed by a worsening at-follow-up. These findings reinforce the hypothesis that the nest effect overweighted COVID-19 fears during the quarantine and highlight the importance of psychological factors in symptom exacerbation.

Keywords: COVID‐19; SARS‐CoV2; disorders of gut brain interaction; functional GI disorders; quarantine.

Grants and funding

None