More Fallout from the COVID-19 Pandemic

In one study, medical admissions of teens with EDs were markedly increased.

Emerging data point to a pattern suggesting that the COVID-19 pandemic has increased calls to ED help lines, and to worsening ED symptoms among adults and adolescents alike. Early evidence has suggested this is leading to an increased need for ED treatment. When Alana K. Otto, MD, MPH, and fellow researchers at the University of Michigan, Ann Arbor, reviewed records of patients 10 to 23 years of age who were admitted to their hospital from March 2017 through March 2021, they saw a significant rise in admissions during the COVID-19 pandemic (Pediatrics. 2021. 148:e2021052201, published online before print).

The authors completed a chart review of adolescents 10 to 23 years of age who were admitted to C.S. Mott Children’s Hospital, Ann Arbor, from March 1, 2017 to March 31, 2021 for medical complications of restrictive EDs. The authors identified 297 ED-related admissions among 248 patients during the study. These included AN, atypical AN, and avoidant or restrictive food intake disorder (ARFID), as well as other specified feeding and EDs or unspecified feeding or eating disorders.

The key finding was that the number of admissions during the first 12 months of the pandemic was more than double the yearly mean for the previous 3 years. The greatest number of these admissions occurred near the end of the study period, 9 to 12 months after the pandemic began. Another trend they identified was that patients admitted during the pandemic were less likely than those admitted before the pandemic to have public insurance.

COVID-19 linked to worsening symptoms

The authors’ findings suggest that COVID-19 pandemic and related precautions may be associated with worsening symptoms among teens with EDs or with the emergence of symptoms among teens at risk of EDs. Features of the pandemic may also contribute to the increased admissions, say the authors. Changes to adolescents’ day-to-day lives, such as school closures and cancellation of organized sports, for example, may disrupt routines related to eating and exercise and may act as an impetus for development of ED behaviors among those at risk. Profound changes in daily lives related to the pandemic, such as social isolation, may also have contributed to the increase in admissions at their hospital.

The authors suggest that those who care for adolescents with EDs may need to be able to adapt rapidly in response to the increasing demands for care during the pandemic. Despite the advantages of telehealth, in-person evaluations to assess weight and nutritional status, vital signs and laboratory studies and evaluation of signs of medical complications that may require hospital admission are essential in the primary care setting. They advise that those who care for adolescents with EDs in inpatient settings be prepared to handle the challenges of the pandemic, particularly because demand for treatment as well as a lack of providers and facilities may only increase.

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