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1. Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine

Author

Alberto C. Helito, Livia Lindoso, Sofia M. Sieczkowska, Camilla Astley, Ligia B. Queiroz, Natalia Rose, Claudia Renata P. Santos, Thalis Bolzan, Rita María I.A. Peralta, Ruth R. Franco, Louise Cominato, Rosa Maria R. Pereira, Uenis Tannuri, Lucia Maria A. Campos, Benito Lourenço, Ricardo K. Toma, Karina Medeiros, Andréia Watanabe, Patricia Moreno Grangeiro, Sylvia C. Farhat, Caio B. Casella, Guilherme V. Polanczyk, Bruno Gualano, Clovis A. Silva, Adriana M. E. Sallum, Amanda Y. Iraha, Bianca P. Ihara, Bruna C. Mazzolani, Claudia A. Martinez, Claudia A. A. Strabelli, Claudia B. Fonseca, Dandara C. C. Lima, Debora N. D. Setoue, Deborah F. P. Roz, Fabiana I. Smaira, Hamilton Roschel, Helena T. Miyatani, Isabela G. Marques, Jane Oba, Juliana C. O. Ferreira, Juliana R. Simon, Katia Kozu, Ligia P. Saccani, Lorena V. M. Martiniano, Luana C. A. Miranda, Luiz E. V. Silva, Moisés F. Laurentino, Nadia E. Aikawa, Neusa K. Sakita, Nicolas Y. Tanigava, Paulo R. A. Pereira, Patrícia Palmeira, Simone S. Angelo, Sofia S. M. Lavorato, Tamires M. Bernardes, Tathiane C. Franco, Vivianne S. L. Viana, Vera P. M. F. R. Barros, and Yingying Zheng

Subjects
COVID-19, Sleep, Adolescent, Chronic Condition, Health-Related Quality of Life, Medicine (General), R5-920
Abstract

OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p

Published
2021
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2. COVID-19 quarantine in adolescents with autoimmune rheumatic diseases: mental health issues and life conditions

Author

Bianca P. Ihara, Lívia M. Lindoso, Debora N. D. Setoue, Nicolas Y. Tanigava, Alberto C. Helito, Juliana R. Simon, Vivianne S. L. Viana, Claudia A. A. Strabelli, Camilla A. A. Pedroso, Sofia M. Sieczkowska, Rosa M. R. Pereira, Nádia E. Aikawa, Katia T. Kozu, Adriana M. Elias, Izabel M. Buscatti, Bruno Gualano, Ligia B. Queiroz, Caio B. Casella, Guilherme V. Polanczyk, Clovis A. A. Silva, and Lucia M. M. A. Campos

Subjects
Sleep Wake Disorders, Adolescent, COVID-19, General Medicine, Arthritis, Juvenile, Dermatomyositis, Cross-Sectional Studies, Mental Health, Rheumatology, Quarantine, Humans, Lupus Erythematosus, Systemic, Prednisone, Female, Child, Pandemics
Abstract

To assess mental health and life conditions in adolescents with autoimmune rheumatic diseases (ARDs) and healthy controls quarantined during COVID-19 pandemic.A cross-sectional study included 155 ARD adolescents and 105 healthy controls. Online survey included self-reported strengths and difficulties questionnaire (SDQ), and a semi-structured questionnaire with demographic data, daily home and school routine, physical activities, and COVID-19 information during the pandemic.Among patients, 56% had juvenile idiopathic arthritis (JIA), 29% juvenile systemic lupus erythematosus (JSLE), and 15% juvenile dermatomyositis (JDM). No differences were found regarding sex, ethnicity, and current age between ARD patients and controls (p 0.05). Abnormal emotional SDQ (38% vs. 35%, p = 0.653) were similar in both groups. Logistic regression analyses in ARD patients demonstrated that female (OR = 2.4; 95%CI 1.0-6.0; p = 0.044) was associated with severe emotional SDQ dysfunction, whereas sleep problems were considered as a risk factor for both worse total SDQ (OR = 2.6; 95%CI 1.2-5.5; p = 0.009) and emotional SDQ scores (OR = 4.6; 95%CI 2.2-9.7; p 0.001). Comparisons between ARD patients with and without current prednisone use showed higher median scores of peer problems in the first group [3 (0-10) vs. 2 (0-7), p = 0.049], whereas similar median and frequencies between JIA, JSLE, and JDM (p 0.05).Approximately one third of JIA, JSLE, and JDM patients presented abnormal total and emotional scores of SDQ during COVID-19 quarantine. Sleep problems were the main factor associated with emotional difficulties in these ARD adolescents. The knowledge of mental health issues rates in adolescents with ARD supports the development of prevention strategies, like sleep hygiene counseling, as well as the references of the affected patients to specialized mental health services, as necessary. Key Points • One third of ARD patients presented mental health issues during COVID-19 quarantine • Sleep problems were associated with emotional difficulties. • It is necessary to warn pediatric rheumatologists about the importance of sleep hygiene counseling.

Published
2022

4. PEDIATRIC SARCOIDOSIS: CASE SERIES

Author

Maria Paula Ribeiro Cardoso, Marianna Ribeiro de Menezes Freire, Levi Medeiros Vieira Paradelas, Jean Paulo Veronesi de Souza, Claudia Alejandra Ayala Strabelli, Katia Tomie Kozu, Nadia Emi Aikawa, and Beatriz Oliveira Leão Carneiro

Published
2022

6. Mental Health Impact in Latin American Pediatric Rheumatologists During the COVID-19 Pandemic

Author

Nadia E. Aikawa, Clovis A. Silva, Caio Borba Casella, Adriana Maluf Elias, Lucia M.A. Campos, Guilherme V. Polanczyk, Euripedes Constantino Miguel, Claudia A A Strabelli, and Katia Kozu

Subjects
Adult, medicine.medical_specialty, Generalized anxiety disorder, Visual analogue scale, Health Personnel, Anxiety, Rheumatology, Internal medicine, medicine, Humans, Child, Pandemics, Depression (differential diagnoses), Aged, Response rate (survey), Depression, SARS-CoV-2, business.industry, COVID-19, Middle Aged, medicine.disease, Mental health, Patient Health Questionnaire, Cross-Sectional Studies, Latin America, Mental Health, Health promotion, Rheumatologists, medicine.symptom, business
Abstract

OBJECTIVE: The aim of this study was to assess mental health in Latin American pediatric rheumatologists (LAPRs) during the COVID-19 pandemic. METHODS: A cross-sectional study was performed with 318 LAPRs based on an online, self-rated survey about clinical practice/mental health impacts during the COVID-19 pandemic. Validated self-reported scales for anxiety (Generalized Anxiety Disorder [GAD-7]) and depression (Patient Health Questionnaire [PHQ-9]) were evaluated. RESULTS: The response rate was 126 of 318 (40%), including 13 of 20 (65%) Latin American countries. Working on the COVID-19 frontline was reported by 27% of LAPRs. Anxiety and moderate/severe depression were observed in 49% and 25%, respectively. No LAPRs reported previous mental health disorders. Deaths of childhood-onset systemic lupus erythematosus and juvenile idiopathic arthritis patients with confirmed/suspected COVID-19 were reported by 8% and 2% of LAPRs, respectively. Further analysis of LAPRs revealed that the median current age was significantly lower in LAPRs with anxiety than in those without anxiety (39 [29-43] vs 45 [30-70] years, p = 0.029). Working on the frontline of COVID-19 (37% vs 17%, p = 0.015), feeling helpless (39% vs 17%, p = 0.009), and experiencing burnout (39% vs 11%, p = 0.0001) were factors significantly higher in LAPRs with anxiety. Median nighttime sleep abnormalities measured by the visual analog scale (VAS) (8 [0-10] vs 4 [0-10], p = 0.009) were significantly higher in the anxiety group, whereas the physical activity VAS was lower (0.5 [0-10] vs 3 [0-10], p = 0.005). A positive Spearman correlation was shown between the GAD-7 score and nighttime sleep abnormality VAS score (r = +0.348, p < 0.001), and a negative correlation was shown between the GAD-7score and physical activity VAS score (r = -0.192, p = 0.031). CONCLUSIONS: Anxiety and depression were relevant to the experience of LAPRs during the COVID-19 pandemic, impacting their mental health. Reporting information about mental health is essential to planning future preventive and health promotion strategies.

Published
2021

7. Laboratory-confirmed pediatric COVID-19 in patients with rheumatic diseases: A case series in a tertiary hospital

Author

V.S. Viana, Lucia M.A. Campos, Clovis A. Silva, Gabriela Nunes Leal, Maria Fernanda Badue Pereira, Adriana M. E. Sallum, Bianca Pires Ihara, Claudia A A Strabelli, Juliana Russo Simon, Katia Kozu, Heloisa Helena de Souza Marques, and Nadia E. Aikawa

Subjects
Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, Risk Assessment, Tertiary Care Centers, COVID-19 Testing, Rheumatology, Risk Factors, Rheumatic Diseases, Health care, medicine, Humans, In patient, Child, Retrospective Studies, SARS-CoV-2, business.industry, COVID-19, Retrospective cohort study, Outcome and Process Assessment, Health Care, Antirheumatic Agents, Emergency medicine, Female, Symptom Assessment, business, Risk assessment, Brazil, Immunosuppressive Agents
Published
2021

8. Poor Sleep quality and health-related quality of life impact in adolescents with and without chronic immunosuppressive conditions during COVID-19 quarantine

Author

Clovis A. Silva, Neusa Keico Sakita, Tathiane Christine Franco, Debora Narumi Demitrol Setoue, Tamires M Bernardes, Rita María I A Peralta, Nicolas Yamada Tanigava, Patricia Moreno Grangeiro, Rosa Maria Rodrigues Pereira, Adriana M. E. Sallum, Nadia E. Aikawa, Andreia Watanabe, Alberto C. Helito, Lorena V.M. Martiniano, Lucia M.A. Campos, Uenis Tannuri, Juliana Russo Simon, Bianca Pires Ihara, Bruna Caruso Mazzolani, Benito Lourenço, Luiz Eduardo Virgilio Silva, Karina Medeiros, Sylvia Costa Lima Farhat, Ricardo Katsuya Toma, Claudia de Brito Fonseca, Lígia Bruni Queiroz, Sofia S.M. Lavorato, Claudia A Martinez, Helena T. Miyatani, Deborah F.P. Roz, Yingying Zheng, Luana Cristina do Amaral Miranda, Patricia Palmeira, Guilherme V. Polanczyk, Isabela G. Marques, Livia Lindoso, Claudia Renata P Santos, Hamilton Roschel, Fabiana Infante Smaira, Louise Cominato, Ruth Rocha Franco, Natalia Rose, Simone Santoro Angelo, Claudia A A Strabelli, Paulo Rogério Pereira, Jane Oba, Ligia P. Saccani, Katia Kozu, Bruno Gualano, V.S. Viana, Amanda Yuri Iraha, Juliana Carvalho Ferreira, Camilla Astley, Moisés F Laurentino, Caio Borba Casella, Sofia Mendes Sieczkowska, Vera P.M.F.R. Barros, Dandara C.C. Lima, and Thalis Bolzan

Subjects
Pediatrics, medicine.medical_specialty, Medicine (General), Adolescent, media_common.quotation_subject, Logistic regression, law.invention, Pittsburgh Sleep Quality Index, Screen time, R5-920, Chronic Condition, Quality of life, law, Surveys and Questionnaires, Quarantine, Medicine, Humans, Quality (business), Child, media_common, business.industry, SARS-CoV-2, COVID-19, General Medicine, Odds ratio, Confidence interval, Cross-Sectional Studies, Health-Related Quality of Life, Chronic Disease, Quality of Life, Original Article, Female, business, Sleep
Abstract

OBJECTIVE: To assess the possible factors that influence sleep quality in adolescents with and without chronic immunosuppressive conditions quarantined during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: This cross-sectional study included 305 adolescents with chronic immunocompromised conditions and 82 healthy adolescents. Online surveys were completed, which included questions on socio-demographic data and self-rated healthcare routine during COVID-19 quarantine and the following validated questionnaires: the Pittsburgh Sleep Quality Index (PSQI), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), and Pediatric Outcome Data Collection Instrument (PODCI). RESULTS: The median current age [14 (10-18) vs. 15 (10-18) years, p=0.847] and frequency of female sex (62% vs. 58%, p=0.571) were similar in adolescents with chronic conditions compared with healthy adolescents. The frequency of poor sleep quality was similar in both groups (38% vs. 48%, p=0.118). Logistic regression analysis, including both healthy adolescents and adolescents with chronic conditions (n=387), demonstrated that self-reported increase in screen time (odds ratio [OR] 3.0; 95% confidence interval [CI] 1.3-6.8; p=0.008) and intrafamilial violence report (OR 2.1; 95% CI 1.2-3.5; p=0.008) were independently associated with poor sleep quality in these adolescents. However, the PODCI global function score was associated with a lower OR for poor sleep quality (OR 0.97; 95% CI 0.94-0.99; p=0.001). Further logistic regression, including only adolescents with chronic conditions (n=305), demonstrated that self-reported increase in screen time (OR 3.1; 95% CI 1.4-6.8; p=0.006) and intrafamilial violence report (OR 2.0; 95% CI 1.2-3.4; p=0.011) remained independently associated with poor quality of sleep, whereas a lower PODCI global function score was associated with a lower OR for sleep quality (OR 0.96; 95% CI 0.94-0.98; p

Published
2021

9. ADOLESCENTS WITH PREEXISTING AUTOIMMUNE RHEUMATIC DISEASES DURING COVID-19 QUARANTINE: HIGH RISK OF MENTAL ISSUES AND IMPACT IN PHYSICAL HEALTH

Author

Katia Kozu, Bruno Gualano, Reinan Tavares Campos, Nicolas Yamada Tanigava, Lúcia Maria de Arruda Campos, Guilherme V. Polanczyk, Rosa Maria Rodrigues Pereira, Juliana Russo Simon, Claudia A A Strabelli, Bianca Pires Ihara, Lívia Maria Lindoso Lima, Lígia Bruni Queiroz, Nádia Emi Aikawa, Adriana Maluf Elias, Camilla Astley Amaral Pedroso, Debora Narumi Demitrol Setoue, Clovis Artur Silva, Caio Borba Casella, and Sofia Mendes Sieczkowska

Subjects
Coronavirus disease 2019 (COVID-19), law, business.industry, Environmental health, Quarantine, Physical health, Medicine, business, law.invention
Published
2021

10. Children with rheumatic diseases and/or using immunosuppressive agents and COVID-19: is this a real concern?

Author

Neusa Keiko Sakita, Juliana Russo Simon, Lúcia Maria de Arruda Campos, Katia Kozu, Maria Fernanda Badue Pereira, Thais de Toledo Fink, Heloisa Helena de Souza Marques, Claudia A A Strabelli, Bianca Pires Ihara, Reinan Tavares Campos, Adriana Maluf Elias, Priscila da Silveira Suguita, Juliana Caires Achili Ferreira, Nádia Emi Aikawa, Vera Bain, and Clovis Artur Silva

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, medicine, Intensive care medicine, business
Published
2021

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