Consequences of the Covid-19 pandemic in children and adolescents with attention deficit hyperactivity disorder - a systematic review

OBJECTIVE

In this systematic review (SR), the authors aimed to identify the possible impact of the social restriction imposed by the Coronavirus Disease-19 (COVID-19) pandemic on children/adolescents with Attention Deficit Hyperactivity Disorder (ADHD).

DATA SOURCES

This SR was registered on PROSPERO CRD42021255569. Eligible articles were selected from PubMed, Embase, and LILACS, according to the following characteristics: ADHD patients < 18 years old, exposed to the COVID-19 pandemic, and the outcomes, medications, relationships, sleep, media use, remote learning, and comorbidities such as depression/sadness, inattention, anxiety, and irritability/aggressiveness. Newcastle-Ottawa Scale (NOS) for cohort, cross-sectional and case-control studies was used to assess methodological quality and the risk of bias.

SUMMARY OF FINDINGS

Of the 222 articles identified, 27 were included, with information on 7,235 patients. Most studies (n = 22) were cross-sectional and received a mean NOS 4.63/10 followed by longitudinal (n = 4) with 3.75/8 points and case-control (n = 1), with 3/9 points. The pandemic affected patients' access to treatment, behavior, and sleep. Difficulties in remote learning and increased use of social media were described, as well as significant and positive changes in relationships with family and peers.

CONCLUSION

Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ADHD were mostly manifested affecting their behavior and sleep patterns.

[Non-utilisation of medical services during the COVID-19 pandemic among persons with chronic diseases]

INTRODUCTION

The COVID-19 pandemic is also impacting the medical care for other diseases. The extent to which people with chronic diseases are affected by the suspension of medical services is investigated-differentiating between patient and provider perspectives.

METHOD

A cross-sectional study was conducted based on data from the longitudinal Hamburg City Health Study (HCHS). The study population was all HCHS participants (a sample of the population of Hamburg, 45-74 years) between April 2020 and November 2021. Utilisation of medical services was collected via the "COVID-19-module" of the HCHS. The chronic conditions included cardiovascular disease, kidney and lung disease, cancer and diabetes mellitus; analyses were descriptive and multivariate.

RESULTS

Of the 2047 participants, 47.9% had at least one previous illness. Of those with pre-existing conditions, 21.4% had at least one healthcare service suspended or an appointment cancelled. In addition, 15.4% stated that they decided by themselves not to attend a doctor's appointment. Specialist care services (43.8% of all cancellations) were cancelled more frequently than general practitioner care (16.6%). After adjustment for age, gender and education, lung disease (OR 1.80; p < 0.008) and cancer (OR 2.33; p < 0.001) were found to be independent risk factors for appointment cancellations by healthcare providers. Of cancellations by patients, 42.2% were due to their fear of an infection with the coronavirus SARS-CoV‑2.

DISCUSSION

Health policy and the media are faced with the challenge of dealing with fears of infection in the population in such a way that they do not lead to an avoidance of necessary care services.

Impact of COVID-19 pandemic on Saudi medical students' career choices and perceptions of health specialties: findings from a national cross-sectional study

BACKGROUND

The COVID-19 pandemic has had a devastating effect on people across the globe. Its impact on medical students' education has also been profound. Here, we aimed to comprehensively determine the nature of this impact on their choice of specialty.

METHOD

A cross-sectional study was conducted among medical students in Saudi Arabia during the pandemic from May to June 2021. Data collected from 1984 medical students were analyzed.

RESULTS

Of the total sample, 810 (40.8%) respondents reported that the pandemic could affect their choice of specialty, with the majority being in the third year (n = 235). Across all class-years, the most common reason chosen was the inability to explore specialties of interest (n = 539, 66.5%). Another reason cited was the inability to support residency application (n = 175, 21.6%). A majority expressed concerns regarding enrollment in research activities. As high as 17.9% (n = 356) of the respondents admitted that they were trying to avoid specialty with frontline exposure to COVID-19, while 353 students (17.8%) were considering local training programs only. While examining certainty levels, of the 1174 (59.2%) students who reported not being affected by the pandemic, 924 (78.7%) had a weak certainty level. The majority were in the third (54.8%, n = 342) and fourth years (44.8%, n = 212).

CONCLUSIONS

This study is the first attempt to thoroughly examine the effect of COVID-19 on medical students' choice of specialty. This effect unfurled in 4 out of 10 surveyed students. Many students reported concerns regarding the inability to explore medical specialties and the inadequacy of obtained clinical knowledge. However, a subsidiary effect was observed among students who were assertive about their choice of specialty. These findings shed new light on the exigency of establishing a career counseling framework designed to meet individual learner needs, thereby galvanizing their morale. Further research could explore the long-term implications of the Saudi Commission for Health Specialties Matching System.