COVID-19 pandemic exacerbates eating disorder by social and intrafamilial isolations: importance of familial relationships (Preprint)

UNSTRUCTURED Background: Coronavirus disease-2019 (COVID-19) pandemic makes children and their parents psychologically stressed. We present a patient with an eating disorder (ED) that rapidly worsened due to stresses and isolations and that was improved by family meeting to reconstitute their relationships, during the pandemic. Case presentation: A father found that his 9-year daughter rapidly lost her weight because of poor oral intake. Her weight had already stopped gaining before the pandemic and rapidly decreased to 22 kg during the pandemic. We diagnosed her as having an ED and administrated nasogastric tube feeding. We guessed that not only social isolations but a disruption of relationship between her and her parents, both of which occurred by the pandemic, also caused her ED. In a family meeting, she revealed that she felt anxious more during the pandemic. After the meeting, her parents rescheduled their works and have dinners together every night. She could eat sufficiently and weigh 31.8 kg. Conclusions: ED children, whose symptoms worsened during the pandemic, are increased during the pandemic since they feel loneliness by social and intrafamilial isolations. Furthermore, the parents are also stressed during the pandemic. Children including those with ED experienced stress directly from the advent of the COVID-19 pandemic and indirectly from their parents. Pediatricians should be concerned that children might experience great stress during and after the pandemic.