Dynamics of the incidence of chronic diseases in adolescents during the COVID-19 pandemic

Relevance. In the context of the pandemic, schoolchildren were transferred to a distance learning format. Forced isolation, prolonged stay at the computer, physical inactivity, high mental stress had an impact on their health. Of practical interest is the analysis of the frequency of chronic diseases during a pandemic in a cohort of adolescents. Purpose: to estimate the incidence of chronic diseases among adolescents during the COVID-19 pandemic. Materials and methods: a prospective, cohort, non-randomized study of adolescents (15-17 years old), (n=221): 116 girls, 105 boys were examined in accordance with the order of the Ministry of Health of the Russian Federation of August 10, 2017 N 514n “On the Procedure for Conducting Preventive Medical Examinations minors”, a comparison was made between the results of the survey in 2019 and 2021. Results. The frequency of mild protein-energy malnutrition increased from 15.1% (2019) to 19.6% (2021), p=0.02. The number of overweight children decreased in the general group from 14.1% to 10.1%, p=0.04, and in the group of boys from 17.2% to 10.6%, p=0.04. Obesity of the I-II degree in the observation groups did not have significant changes in the number of diagnosed cases, however, in the group of boys in 2021, obesity of the III degree was detected. According to the results of observation against the backdrop of a pandemic in adolescents, the frequency of chronic diseases has significantly increased: pathology of the organ of vision - by 1.4 times, pathology of the musculoskeletal system - by 2.8 times, pathology of the nervous system - by 7 times, gynecological diseases - by 1, 7 times. Conclusion. The overall frequency of detected pathology increased by 1.6 times, due to diseases of the eyes, blood system, musculoskeletal system, endocrine, nervous and reproductive systems. It is likely that physical inactivity and a high level of stress, causing a long-term hormonal imbalance, played a negative role during the period of covid restrictions. At present, thanks to the opening of rehabilitation departments providing specialized medical care within the framework of the compulsory medical insurance system, this category of patients throughout the Russian Federation will have the opportunity for personalized correction of the identified pathology.

adolescents, COVID-19, health status, incidence of chronic diseases distance learning, covid restrictions, chronic diseases

1. Gorelov A.V., Nikolaeva S. V., Akimkin V. G. Coronavirus infection COVID-19 in children in the Russian Federation. Infectious diseases. 2020; 18(3): 15-20. (In Russ.) doi: 10.20953/1729-9225-2020-3-15-20.@@ Горелов А. В., Николаева С. В., Акимкин В. Г. Коронавирусная инфекция COVID-19 у детей в Российской Федерации. Инфекционные болезни. 2020; 18(3): 15-20.

2. Lai C.-C., Shih T.-P., Ko W.-C., Tang H.-J., Hsueh P.-R. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Coronavirus Disease-2019 (COVID-19): The Epidemic and the Challenges.Int. J. Antimicrob. Agents. 2020 Mar;55(3):105924. doi: 10.1016/j.ijantimicag.2020.105924.

3. Han E., Tan M. M.J., Turk E., Sridhar D., Leung G. M., Shibuya K., et al. Lessons Learnt from Easing COVID-19 Restrictions: An Analysis of Countries and Regions in Asia Pacific and Europe. Lancet. 2020 Nov 7;396(10261):1525-1534. doi: 10.1016/S0140-6736(20)32007-9.

4. Chang T.-H., Chen Y.-C., Chen W.-Y., Chen C.-Y., Hsu W.-Y., Chou Y., et al. Weight Gain Associated with COVID-19 Lockdown in Children and Adolescents: A Systematic Review and Meta-Analysis. Nutrients. 2021 Oct 19;13(10):3668. doi: 10.3390/nu13103668.

5. Bremner J.D., Moazzami K., Wittbrodt M. T., Nye J. A., Lima B. B., Gillespie C. F., et al. Diet, Stress and Mental Health. Nutrients. 2020 Aug 13;12(8):2428. doi: 10.3390/nu12082428.

6. Aksenova E.I., Podchernina A. M., Kachkurkina Ya.O., Bocharova M. O., Kurakina T. Yu. Analysis of the incidence of children in social isolation during the period of COVID-19. City Healthсare. 2022;3(2):34-50. doi: 10.47619/2713-2617.zm.2022.v.3i2;34-50.@@ Аксенова Е. И., Подчернина А. М., Качкуркина Я. О., Бочарова М. О., Куракина Т. Ю. Анализ заболеваемости детей в условиях социальной изоляции в период COVID-19// Здоровье мегаполиса. - 2022. - Т. 3. - № 2. - С. 34-50 doi: 10.47619/2713-2617.zm.2022.v.3i2; 34-50.

7. Kapitonov V.F., Shurova O. A. Morbidity of children of different age groups in pre-epidemic 2019 and the period of the COVID-19 coronavirus pandemic. Social’nye aspekty zdorov’a naselenia / Social aspects of population health [serial online] 2021; 67(4):4. Available from: http://vestnik.mednet.ru/content/view/1283/30/lang_ru (In Russ.) doi: 10.21045/2071-5021-2021-67-4-4. @@ Капитонов В.Ф, Шурова О. А. Заболеваемость детей различных возрастных групп в доэпидемический 2019 г. и период пандемии коронавирусной инфекции COVID-19. Социальные аспекты здоровья населения [сетевое издание] 2021; 67(4):4. URL: http://vestnik.mednet.ru/content/view/1283/30/lang_ru doi: 10.21045/2071-5021-2021-67-4-4.

8. Deal B.J., Huffman M. D., Binns H., Stone N. J. Perspective: Childhood Obesity Requires New Strategies for Prevention. Adv. Nutr. 2020 Sep 1;11(5):1071-1078. doi: 10.1093/advances/nmaa040.

9. Fursov A.B., Ospanov O. B., Fursov R. A. Obesity and COVID-19 - signs of convergence of two pandemics. Recommendations for combating obesity based on the principles of “ROOTS”. Obesity and metabolism. 2021;18(4):456-464. (In Russ.) doi: 10.14341/omet12745.@@ Фурсов А. Б., Оспанов О. Б., Фурсов Р. А. Ожирение и COVID-19 - признаки конвергенции двух пандемий. Рекомендации по борьбе с ожирением, основанные на принципах «ROOTS». Ожирение и метаболизм. 2021;18(4):456-464. doi: 10.14341/omet12745.

10. Khan M.A., Moverley Smith J. E. “Covibesity”, a New Pandemic. Obes. Med. 2020 Sep;19:100282. doi: 10.1016/j.obmed.2020.100282.

11. Shvarts V. I. Inflammation of the adipose tissue (Part 4). Obesity: a new infectious disease? (a literature review). Problems of Endocrinology. 2011;57(5):63-71. (In Russ.) doi: 10.14341/probl201157563-71.@@ Шварц В. Я. Воспаление жировой ткани (часть 4). Ожирение - новое инфекционное заболевание? (обзор литературы). Проблемы Эндокринологии. 2011;57(5):63-71. doi: 10.14341/probl201157563-71.

12. Simonnet A., Chetboun M., Poissy J., Raverdy V., Noulette J., Duhamel A., et al. High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation. Obesity (Silver Spring). 2020 Jul;28(7):1195-1199. doi: 10.1002/oby.22831.

13. Singer M., Bulled N., Ostrach B., Mendenhall E. Syndemics and the Biosocial Conception of Health. Lancet. 2017 Mar 4;389(10072):941-950. doi: 10.1016/S0140-6736(17)30003-X.

14. Potupchik T.V., Evert L. S., Kostyuchenko Yu.R., Vlasova E. N., Fotekova T. A. Psychosomatic status of children and adolescents during the COVID-19 pandemic. Doctor.Ru. 2022; 21(7): 34-40. (In Russ.) doi: 10.31550/1727-2378-2022-21-7-34-40.@@ Потупчик Т. В., Эверт Л. С., Костюченко Ю. Р., Власова Е. Н., Фотекова Т. А. Психосоматический статус детей и подростков во время пандемии COVID-19. Доктор.Ру. 2022; 21(7): 34-40. doi: 10.31550/1727-2378-2022-21-7-34-40.

15. Salova M. N., Zhdanova L. A., Shemanaeva E. V., Klepikova T. A. Impared health status in children suffered from new coronavirus infection. Bulletin of the Ivanovo Medical Academy. 2022; 27(1):16-42. (In Russ.) doi: 10.52246/1606-8157_2022_27_1_16.@@ Салова М. Н., Жданова Л. А., Шеманаева Е. В., Клепикова Т. А. Характеристика нарушений здоровья детей, перенесших новую коронавирусную инфекцию. Вестник Ивановской медицинской академии. 2022; 27(1):16-42. doi: 10.52246/1606-8157_2022_27_1_16.

16. Osipov A. Yu., Kleptsova T. N., Lepilina T. V., Vorontsov S. V., Dan’kova M. Yu. Impact of the COVID-19 pandemic on physical activity of university students. Uchenye zapiski universiteta imeni P. F. Lesgafta = Scientific notes of the University named after P. F. Lesgaft. 2021. - No. 3 (193). pp. 313-317. (In Russ.) doi: 10.34835/issn.2308-1961.2021.3.p313-317.@@ Осипов А. Ю., Клепцова Т. Н., Лепилина Т. В., Воронцов С.В, Данькова М. Ю. Влияние пандемии COVID-19 на физическую активность студенческой молодежи. Ученые записки университета имени П. Ф. Лесгафта. 2021;3 (193):313-317. doi: 10.34835/issn.2308-1961.2021.3.p313-317.

17. Shurygina V.V., Kostylev D. V., Kostyleva L. N., Reshetnik A. S., Rakhmattulina E. A. Examining regular physical activity during a pandemic. Uchenye zapiski universiteta imeni P. F. Lesgafta = Scientific notes of the University named after P. F. Lesgaft. 2021;11 (189):578-581. (In Russ.) doi: 10.34835/issn.2308-1961.2020.11.p578-581.@@ Шурыгина В. В., Костылев Д. В., Костылева Л. Н., Решетник А. С., Рахматтулина Э. А. Изучение регулярной физической активности в период пандемии. Ученые записки университета имени П. Ф. Лесгафта. - 2021. - № 11 (189). С. 578-581. doi: 10.34835/issn.2308-1961.2020.11.p578-581.

18. Shmakov E.V. [The influence of physical activity on the performance of the visual analyzer in young athletes with mild myopia]. Scientific review. Series 2: Human Science. 2014;3:82-89. (In Russ.)@@ Шмаков Е. В. Влияние физической активности на показатели зрительного анализатора у юных спортсменов с миопией слабой степени. Научное обозрение. Серия 2: Гуманитарные науки. 2014;3:82-89.

19. Shubochkina E.I., Vyatleva O. A., Blinova E. G. Risks of Visual Impairment and Its Progression in Children and Adolescents under Modern Conditions of Education and Upbringing: A Scientific Review. Public Health and Life Environment - PH&LE. 2022; (4):22-30. (In Russ.) doi: 10.35627/10.35627/2219-5238/2022-30-4-22-30.@@ Шубочкина Е. И., Вятлева О. А., Блинова Е. Г. Риски ухудшения зрения и его прогрессирования у детей и подростков в современных условиях обучения и воспитания (научный обзор). Здоровье населения и среда обитания - ЗНиСО. 2022;(4):22-30. doi: 10.35627/10.35627/2219-5238/2022-30-4-22-30.

20. Demidova T. Yu., Volkova E. I., Gritskevich E. Yu. Features of the course and consequences of COVID-19 in overweight and obese patients. Lessons from the current pandemic. Obesity and metabolism. 2020;17(4):375-384. (In Russ.) doi: 10.14341/omet12663.@@ Демидова Т. Ю., Волкова Е. И., Грицкевич Е. Ю. Особенности течения и последствия COVID-19 у пациентов с избыточным весом и ожирением. Уроки текущей пандемии. Ожирение и метаболизм. 2020;17(4):375-384. doi: 10.14341/omet12663.

21. Brooks C.G., Spencer J. R., Sprafka J. M., Roehl K. A., Ma J., Londhe A. A. et al. Pediatric BMI Changes during COVID-19 Pandemic: An Electronic Health Record-Based Retrospective Cohort Study. EClinicalMedicine. 2021 Jul 16;38:101026. doi: 10.1016/j.eclinm.2021.101026.

22. Hu J., Liu J., Wang J., Shen M., Ge W., Shen H., et al. Unfavorable Progression of Obesity in Children and Adolescents Due to COVID-19 Pandemic: A School-Based Survey in China. Obesity (Silver Spring). 2021 Nov;29(11):1907-1915. doi: 10.1002/oby.23276.

23. Qiu N., He H., Qiao L., Ding Y., Ji S., Guo X., et al. Sex Differences in Changes in BMI and Blood Pressure in Chinese School-Aged Children during the COVID-19 Quarantine.Int J Obes (Lond). 2021 Sep;45(9):2132-2136. doi: 10.1038/s41366-021-00871-w.

24. Cipolla C., Curatola A., Ferretti S., Giugno G., Condemi C., Delogu A. B., et al. Eating Habits and Lifestyle in Children with Obesity during the COVID19 Lockdown: A Survey in an Italian Center. Acta Biomed. 2021 May 12;92(2): e2021196. doi: 10.23750/abm.v92i2.10912.

25. Kim E.S., Kwon Y., Choe Y. H., Kim M. J. COVID-19-Related School Closing Aggravate Obesity and Glucose Intolerance in Pediatric Patients with Obesity. Sci. Rep. 2021 Mar 9;11(1):5494. doi: 10.1038/s41598-021-84766-w.

26. Doom J.R., Lumeng J. C., Sturza J., Kaciroti N., Vazquez D. M., Miller A. L. Longitudinal Associations between Overweight/Obesity and Stress Biology in Low-Income Children.Int. J. Obes (Lond). 2020 Mar;44(3):646-655. doi: 10.1038/s41366-019-0447-4.

27. De Figueiredo C. S., Sandre P. C., Portugal L. C.L., Mázala-de-Oliveira T., da Silva Chagas L., Raony Í., et al. COVID-19 Pandemic Impact on Children and Adolescents’ Mental Health: Biological, Environmental, and Social Factors. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2021 Mar 2;106:110171. doi: 10.1016/j.pnpbp.2020.110171.

28. Singh S., Roy D., Sinha K., Parveen S., Sharma G., Joshi G. Impact of COVID-19 and Lockdown on Mental Health of Children and Adolescents: A Narrative Review with Recommendations. Psychiatry Res. 2020 Nov;293:113429. doi: 10.1016/j.psychres.2020.113429.

29. Moreno J.P., Johnston C. A., Chen T.-A., O’Connor T. A., Hughes S. O., Baranowski J., et al. Seasonal Variability in Weight Change during Elementary School. Obesity (Silver Spring). 2015 Feb;23(2):422-8. doi: 10.1002/oby.20977.

30. Pietrobelli A., Pecoraro L., Ferruzzi A., Heo M., Faith M., Zoller T., et al. Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study. Obesity (Silver Spring). 2020 Aug;28(8):1382-1385. doi: 10.1002/oby.22861.