The association of covid-19 infection with changes in dietary and sleeping patterns, lifestyle and behavioral changes in children in Lebanon, 2021

Abstract

Introduction: COVID-19 infection has affected the daily lives of billions of people worldwide, either because of the disease itself and its associated morbidity and mortality, or because of the engendered non-pharmacological interventions (NPI) altering almost all aspects of our daily lives. While most of the studies tackle either the effect of COVID 19 infection in adults, or the impact of induced NPI on both adults and children, little is known yet about the effect of COVID-19 infection in children. To date, no studies have yet tackled how COVID-19 infection has affected this age group in terms of clinical and lifestyle aspects. Objectives: The study aimed to: i) describe the clinical symptoms in children ≤18 years diagnosed with COVID-19 and residing in Lebanon; ii) investigate the COVID-19 impact on children’s dietary and sleeping patterns, lifestyle and behavior changes. Methods: The study population included COVID-19 cases ≤ 18 years, residing in Lebanon, confirmed by rRTPCR and reported to the Epidemiological Surveillance Unit at Ministry of Public Health (ESU-MOH) between May and July 2021. A total of 385 cases, stratified by age groups (0-9; 10-19 years) and 26 districts, was included. A structured questionnaire was administered through phone call interviews in order to collect information about children’s demographics, clinical signs and symptoms, comorbidities, as well as changes in their dietary and sleeping habits, lifestyle, attitude and behavior changes associated with their COVID-19 infection. Data entry was performed using Epidata version 4.6.0.2 and analyzed using SPSS version 20. Results: The mean age was calculated to be x̄=13.43 with a standard deviation Std. Dev.= 4.034. 18.7% (72) of the participants belong to the 0-9 years old stratum, while 81.3% (313) belong to the 10-18 years old stratum. 87.3% reported experiencing symptoms during their COVID-19 infection. The most common symptoms witnessed consist of fever (38+), experienced by 29.3% of the symptomatic individuals, myalgia/arthralgia (11.4%), headache (11.2%), cough (8.9%), as well as anosmia (8.9%). 15.6% claimed they are affected by certain predicaments. 1.6% of them were hospitalized due to their COVID-19 infection. Eating Patterns: 62.3% the care-takers did not notice any change in the children’s weight. 49.4% of the parents noticed a decrease in children’s food consumption. 65.5% of the guardians did not nice any change in children’s food preference. 45.2% of the parents noticed an increase in children’s water intake. Sleeping Patterns: 46.5% of the parents did not notice any change in their children’s sleeping hours. 68.3% of the parents did not notice any change in children’s sleeping quality. Lifestyle & Behavior: 94.5% of the parents reported their child complied with a fourteen-day isolation period. 64.8% stated their child did not experience feelings of anxiety regarding his/her health during the infection. 64.2% of the parents stated they did not notice any change in children’s attitude towards their health during their infection. 69.1% of the guardians claimed other family members were affected by the coronavirus during their child’s infection, where 56.6% of them stated their child worried about the death of that member. 69.9% of the guardians declared they noticed an increase in their children’s daily screen time for entertainment. 51.8% stated their children attended online classes, where 83.8% stated their child was able to concentrate on the material. 59.2% of the legal guardians attested their child’s attitude remained the same during the infection. Chi-square tests were performed to divulge the presence of true associations between categorical variables. The Gender variable was associated with the Change in the Child’s attitude during his/her COVID-19 Infection. Gender was also associated with the Coronavirus Infection Status of the Implicated Children’s Family Members. Gender was associated with the Children’s Compliance to a Fourteen-Day Isolation Period over the course of their infection. The Age Groups variable was found to be associated with the Coronavirus Infection Status of the Implicated Children’s Family Members. Discussion: The study was considered the earliest attempt to explore the clinical and behavioral characteristics associated with COVID-19 infection in children in Lebanon. The findings would assist policy makers in tailoring COVID-19 clinical as well as social and behavioral recovery programs.