Physical and mental health during COVID-19 quarantine in adolescents with chronic immunocompromised conditions and inflammatory bowel disease

Abstract Background Social connection is a fundamental part of the psychosocial development in adolescence; therefore quarantine has a potentially negative impact in the physical and mental health. Therefore, the objective of this study was to evaluate physical and mental health indicators in adolescents with preexisting chronic immunocompromised conditions, including inflammatory bowel disease(IBD) compare to healthy adolescents during COVID-19 quarantine. Methods A cross-sectional study included 355 adolescents with chronic conditions(IBD, n=44) and 111 healthy adolescents. An online self-rated survey was used to investigate socio-demographic features, healthcare routine and the quarantine impact on physical and mental health. Validated self-reported version of Strengths and Difficulties Questionnaire(SDQ) evaluated psychosocial functioning. Results No differences were observed between adolescents with preexisting chronic immunocompromised conditions versus healthy adolescents during quarantine of COVID-19 pandemic for age, sex and ethnicity, as well as for household conditions and schooling(p>0.05). The frequencies of psychosocial functioning abnormalities according to total difficulties SDQ score were high and similar in patients and controls(30% vs. 31%, p=0.775). Logistic regression analysis showed that being female(OR=1.965, 95%CI=1.091–3.541,p=0.024), fear of underlying disease activity/complication(OR=1.009, 95%CI=1.001–1.018, p=0.030) were associated with severe psychosocial dysfunction in adolescents with chronic conditions, whereas school homework(OR=0.449, 95%CI=0.206–0.981,p=0.045), physical activity (OR=0.990, 95%CI=0.981–0.999,p=0.030) and sleep quality(OR=0.986, 95%CI=0.975–0.998,p=0.017) were protective factors. Further analysis showed similar median age, fear (disease activity/complication, immunosuppressive use, and COVID-19), physical activity, sleep difficulties, and total difficulties SDQ score in IBD adolescents versus with chronic conditions (p>0.05). The frequencies of psychosocial functioning abnormalities according to total difficulties score of SDQ were high and similar in IBD adolescents vs. chronic condition(37% vs. 29%, p=0.329), as well sleep difficulties(34% vs. 32%, p=0.797). Conclusion Being female, fear of underlying disease activity/complication and household members working outside of home were relevant issues for adolescents with preexisting chronic conditions. We also demonstrated that adolescents with IBD during COVID-19 quarantine had high risk of adverse health indicators, particularly psychosocial functioning and sleep difficulties. This study reinforces the need to establish mental health strategies for teens with chronic conditions, particularly during pandemic periods.