Emergency Department access of patients with eating disorders and the impact of SARS-CoV-2 pandemic: a 20 years retrospective analysis

1Emergency Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
2Università Cattolica del Sacro Cuore, Rome, Italy
3Department of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
4Department of Translational Medicine and Surgery, Unit of Endocrinology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy


INTRODUCTION. Patients suffering from eating disorders represent a highly vulnerable and fragile population. The recent SARS-Co-2 pandemic and its impact on public health and behavioral habits created the conditions for an overall increase in most types of mental disturbances, thus including eating disorders. The combined effects of the psychological stress (deriving from confinement and forced cohabitation, loneliness, sadness, fear, anxiety, and concerns about the uncertainty of life) had deeply increased the psychological discomfort of these patients, with possibly a significant impact on their mental status.
AIM OF THE STUDY. To evaluate the impact of the SARS-CoV-2 pandemic on the onset of acute complications of patients suffering from eating disorders through the comparison of the rates of access of these patients to a national reference emergency hub in the last 2 years with those recorded in the previous pre-pandemic period.
PATIENTS AND METHODS. Our study retrospectively reviewed the clinical records of patients affected by eating disorders admitted to the Emergency Department (ED) of Policlinico A. Gemelli, IRCSS of Rome for acute medical complications over 20 years (2003-August 2022). The rate of access and ward admission in the non-pandemic (2003-2019) and the pandemic (2020-2022) periods were compared. Overall, 344 patients (21 males and 325 females), were included in the study cohort (age 28.0 [IQ range 20.8-36.8]).
RESULTS. The patients referring to our ED during the 2 pandemic period were 61 (2 males, 59 females) aged 23.7 [19.3-31.6], while the non-pandemic period subjects were 283 (17 males, 266 females) aged 23.7 [19.3-31.6]. The patients in the pandemic period were significantly younger than in previous years (p<0.01). The number of patients evaluated and admitted to the ward per year almost doubled in the pandemic period. The number of visits per month was significantly higher in the pandemic period compared to the non-pandemic period (1.91 vs. 1.39, p<0.01), as well as the number of admission/per month (1.19 vs. 0.90, p<0.01).
CONCLUSIONS. Our results, showing a one-third increment of the year/rate of ED admission of patients suffering from eating disorders, confirm the high impact of the SARS-CoV-2 pandemic on the clinical decompensation of subjects suffering from eating disorders. The modifications of the behavioral habits (confinement, restriction, loneliness, fear, anxiety, and familiar insecurity) and possibly dietary changes induced by the SARS-CoV-2 pandemic may cause a negative evolution in vulnerable and younger individuals.

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Publication history:

Submission date: Oct 04th, 2022
Revised on: Oct 05th, 2022
Accepted on: Oct 07th, 2022
Published online: Oct 17th, 2022

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