Pediatric emergency care admissions for somatic symptom disorders during the COVID-19 pandemic

During the COVID-19 pandemic, children and adolescents with psychiatric disorders experienced an exacerbation of their symptoms with more access to the emergency department (ED). However, little is known about the experience of somatic symptom disorders (SSDs) during the COVID-19 pandemic in children. Therefore, we aimed to compare the rates of pediatric ED admissions for SSDs before and during the COVID-19 pandemic and to understand whether the relative risk of ED admissions for SSDs changed between the two periods. We retrospectively enrolled all children between 4 and 14 years admitted for SSDs in the pediatric ED of Santobono-Pausilipon Hospital, Naples, Italy, from March 11th, 2020, to March 11th, 2021 (pandemic period), and in the same time period of the previous year (pre-pandemic period). We identified 205/95,743 (0,21%) children with SSDs presenting in ED in the pre-pandemic year and 160/40,165 (0,39%) in the pandemic year (p < 0.05). Considering the accesses for age, we observed a relative decrease of the accesses for SSDs over 12 years old (IRR 0,59; CI 0,39-0,88), while we found no differences under 12 years old (IRR 0,87; CI 0,68-1,10).   Conclusion: In this study, we found that despite the massive decrease in pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders' admissions to the pediatric ED increased, suggesting an impact of the pandemic also on pediatric psychiatric disorders. What is Known: • During the COVID -19 pandemic, children and adolescents with a psychiatric disorder experienced exacerbation of their symptoms with more accesses in Emergency Department. What is New: • We found that despite the massive decrease of the pediatric admissions due to the COVID-19 pandemic, somatic symptom disorders admissions in healthy children to the pediatric Emergency Department increased ,suggesting an impact of the pandemic also on the pediatric psychiatric disorders.

Pulsatile growth pattern during catch-up growth in childhood coeliac disease

Catch-up growth in coeliac disease was thought to be a continuous process and hence linear models have been proposed to interpret the pattern of catch-up growth. Observed longitudinal data do not fit a linear model adequately. The aim of this study is to clarify the pattern of short-term catch-up growth in coeliac patients. Twenty-one coeliac children (aged 6-24 months) entered the study and were monitored at short-time intervals. All showed a "pulsatile" pattern of growth velocity for height, weight, leg length, subscapular and triceps skinfolds. Peaks alternated with troughs at a mean time of 62 days for the whole set of measurements. The periodicity was remarkably stable. The size of the peaks decreased with time on a gluten-free diet. Catch-up growth is a discontinuous process made up of a sequence of bursts of growth followed by a resting phase. This provides strong evidence for the possibility that short-term growth may be pulsatile.