Indirect impact of COVID-19 pandemics on health-related quality of life and specialized health care in children with chronic diseases in Children’s Clinical University Hospital of Latvia

COVID-19 can have a direct and indirect impact on the course of a chronically ill child's disease and health-related quality of life (HRQoL). The aim of this study was to analyze the factors that could affect the HRQoL of the patient and the patient's caregiver during the COVID-19 pandemic. University hospital (CCUH) from IX till XII 2020 in 4 diagnostic cohorts – type 1 diabetes (T1D), bronchial asthma (BA), inflammatory bowel disease (IBD) and cystic fibrosis (CF). Data were collected through a validated questionnaire PedsQL consisting of 4 main dimensions: physical health and activities, emotional health, social activities and school activities. The following number of children were enrolled in the study: 108 patients with DM1, 101 patients with BA, 12 IBD patients and 15 patients with CF. Analyzing the patients' HRQoL score in 4 dimensions: the physical health and activities - the highest HRQoL score among 4 chronic disease groups was achieved by patients with DM1 85.04, the lowest - patients with CF and IBD 75.00; emotional health - the highest HRQoL score was achieved by patients with BA, DM1 and IBD 70.00, the lowest - CF 67.50; social activities - the highest score - IBD 90.00, the lowest - CF 77.50, school activities – the highest HRQoL score - BA 75.00, the lowest - CF and IBD 65.00. Assessed by their treating physician 27.5% of all patient’s clinical condition have worsened during the pandemic and 12.3% of the patients did not receive the necessary specialized care during the pandemic. HRQoL is affected in all disease groups included in the study and analyzing the patients' HRQoL score in 4 dimensions the lowest numbers of HRQoL in all dimensions was observed between CF patients. 27.5% of all patient’s clinical condition have worsened during the COVID-19 pandemic.