Consequences of the Covid-19 pandemic in children and adolescents with attention deficit hyperactivity disorder - a systematic review.

OBJECTIVE: In this systematic review (SR), the authors aimed to identify the possible impact of the social restriction imposed by the Coronavirus Disease-19 (COVID-19) pandemic on children/adolescents with Attention Deficit Hyperactivity Disorder (ADHD). DATA SOURCES: This SR was registered on PROSPERO CRD42021255569. Eligible articles were selected from PubMed, Embase, and LILACS, according to the following characteristics: ADHD patients < 18 years old, exposed to the COVID-19 pandemic, and the outcomes, medications, relationships, sleep, media use, remote learning, and comorbidities such as depression/sadness, inattention, anxiety, and irritability/aggressiveness. Newcastle-Ottawa Scale (NOS) for cohort, cross-sectional and case-control studies was used to assess methodological quality and the risk of bias. SUMMARY OF FINDINGS: Of the 222 articles identified, 27 were included, with information on 7,235 patients. Most studies (n = 22) were cross-sectional and received a mean NOS 4.63/10 followed by longitudinal (n = 4) with 3.75/8 points and case-control (n = 1), with 3/9 points. The pandemic affected patients' access to treatment, behavior, and sleep. Difficulties in remote learning and increased use of social media were described, as well as significant and positive changes in relationships with family and peers. CONCLUSION: Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ADHD were mostly manifested affecting their behavior and sleep patterns.

Consequences of the Covid-19 pandemic in children and adolescents with attention deficit hyperactivity disorder - a systematic review

Abstract Objective In this systematic review (SR), the authors aimed to identify the possible impact of the social restriction imposed by the Coronavirus Disease-19 (COVID-19) pandemic on children/adolescents with Attention Deficit Hyperactivity Disorder (ADHD). Data sources This SR was registered on PROSPERO CRD42021255569. Eligible articles were selected from PubMed, Embase, and LILACS, according to the following characteristics: ADHD patients < 18 years old, exposed to the COVID-19 pandemic, and the outcomes, medications, relationships, sleep, media use, remote learning, and comorbidities such as depression/sadness, inattention, anxiety, and irritability/aggressiveness. Newcastle-Ottawa Scale (NOS) for cohort, cross-sectional and case-control studies was used to assess methodological quality and the risk of bias. Summary of findings Of the 222 articles identified, 27 were included, with information on 7,235 patients. Most studies (n = 22) were cross-sectional and received a mean NOS 4.63/10 followed by longitudinal (n = 4) with 3.75/8 points and case-control (n = 1), with 3/9 points. The pandemic affected patients' access to treatment, behavior, and sleep. Difficulties in remote learning and increased use of social media were described, as well as significant and positive changes in relationships with family and peers. Conclusion Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ADHD were mostly manifested affecting their behavior and sleep patterns.

Health consequences and daily life modifications in children and adolescents with epilepsy during the COVID-19 pandemic - a systematic review: Running Title: Covid-19 Pandemic in Children/Adolescents with Epilepsy.

PURPOSE: To describe the impact of the COVID-19 pandemic on the health care and daily life of children and adolescents with epilepsy. METHODS: This systematic review followed the preferred reporting items guidelines and was registered on the PROSPERO platform (CRD42021255931). The PECO (Patient, Exposure, Comparison, Outcome) framework criteria were as follows: people with epilepsy (0-18 years old); exposed to the COVID-19 pandemic; and outcomes, including epilepsy type, time of clinical diagnosis, seizure exacerbation, treatment and medications, need for emergency because of seizures, sleep, behavior, comorbidities and/or concerns, social and/or economic impact, insurance status, electronic device use, telemedicine, and distance learning. Literature searches for cross-sectional and longitudinal studies were conducted on Embase and PubMed. The methodological quality of identified studies was assessed using the Newcastle‒Ottawa Scale (NOS). RESULTS: Data were extracted from 23 eligible out of 597 identified articles and included 31,673 patients. The mean NOS scores for cross-sectional study design was 3.84/10, and for longitudinal, it was 3.5/8 stars. Seizure exacerbations were reported in three studies, difficulties with access to anti-seizure medications in two, changes in dosage in five, and visit postponed or cancelation in five studies. Problems with sleep were highlighted in three, issues related to distance learning in two, an increased time spent on electronic devices in three, and increased behavioral problems in eight studies. Telemedicine, when available, was described as useful and supporting patient's needs. CONCLUSION: The pandemic affected the health care and lifestyle of young individuals with epilepsy. The main problems described revolved around seizure control, accessing anti-seizure medication, sleep and behavioral complains.

Motor and cognitive outcomes of neonates with low birth weight in Brazil: a systematic review and meta-analysis.

BACKGROUND: Data on the outcomes of preterm newborns in South American countries are scarce. Given the great effect of low birth weight (LBW) and/or prematurity on children's neurodevelopment, it is extremely necessary to conduct studies on these phenomena in greater depth in more heterogeneous populations such as those ones from countries with limited resources. METHODS: We conducted a comprehensive literature search on databases including PubMed, the Cochrane Library, and Web of Science for articles published in Portuguese and English up to March 2021 involving children born and evaluated in Brazil. The analysis of the risk of bias was adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and used to evaluate the methodology of the included studies. RESULTS: From the eligible trials, 25 articles were selected for qualitative synthesis, and 5 of those, for quantitative synthesis (meta-analysis). The meta-analyses showed that children born with LBW presented lower scores on motor development when compared with controls (standardized mean difference: -1.15; 95% confidence interval [95%CI]: -1.56--0.73]; I2: 80%) and also scored lower in terms of cognitive development (standardized mean difference: -0.71; 95% CI: -0.99--0.44; I2: 67%). CONCLUSION: The results of the present study reinforce that impaired motor and cognitive functions can be a significant long-term outcome of LBW. The lower the gestational age at delivery, the higher the risk of impairment in those domains. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database under number CRD42019112403.

ANTECEDENTES: Dados sobre desfechos de recém-nascidos prematuros em países da América do Sul são escassos. Dado o grande efeito do baixo peso ao nascer (BPN) e/ou da prematuridade no neurodesenvolvimento das crianças, é extremamente necessária a realização de estudos que investiguem esses fenômenos com maior profundidade em populações mais heterogêneas. MéTODOS: Realizou-se uma busca da literatura em bases de dados, incluindo PubMed, Cochrane Library e Web of Science, por artigos publicados em português e inglês até março de 2021 envolvendo crianças nascidas e avaliadas no Brasil. A análise de risco de viés foi adaptada da declaração de Fortalecimento do Relato de Estudos Observacionais em Epidemiologia (Strengthening the Reporting of Observational Studies in Epidemiology, STROBE), que foi utilizada para avaliar a metodologia dos estudos. RESULTADOS: Dos estudos elegíveis, 25 artigos foram selecionados para síntese qualitativa, e 5 desses 25, para síntese quantitativa (metanálise). As metanálises mostraram que crianças nascidas com BPN apresentaram pontuação menor em desenvolvimento motor quando comparadas aos controles (diferença média padronizada, −1,15; intervalo de confiança de 95% [IC95%]: −1,56­−0,73]; I2: 80%) e pontuação também menor em termos de desenvolvimento cognitivo (diferença média padronizada, −0,71; IC95%: −0,992−0,44; I2: 67%). CONCLUSãO: Os resultados deste estudo reforçam que o comprometimento das funções motoras e cognitivas pode ser um desfecho significativo de longo prazo do BPN. Quanto menor a idade gestacional no momento do parto, maior o risco de prejuízo nesses domínios. O protocolo do estudo foi registrado no banco de dados International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42019112403.

The Influence of Parental Sleep and Experiences Related to COVID-19 on Sleep in Children and Adolescents between 2020 and 2021 in Brazil.

The study aimed to evaluate the influence of parental sleep and experiences related to COVID-19 on sleep changes in children and adolescents in the period between 2020 and 2021 in Brazil and further compare the sleep of adults with and without children. This is a longitudinal web-survey study. Participants were invited to respond to a questionnaire regarding sleep characteristics, mental health issues, and work/lifestyle modifications in two waves of the pandemic (April-July 2020 and 2021). A total of 1172 adults answered both questionnaires, and 281 were dyads (parent-child/adolescent). Parent and non-parent adult responders had similar sociodemographic data, with a predominance of the female sex and self-declared white skin color prevailing along with higher levels of education in both groups. The prevalence of sleep problems in adults varied from 20.6% to 30.2% in the parent group and from 16.9% to 30.1% in non-parents. The prevalence of sleep problems in children and adolescents raised from 2020 to 2021 (respectively, 48% and 49.5%) but differences were not statistically significant. The multivariate logistic model showed in both years that changes in children's/adolescents' sleep was related to parents working at home, infected family/friends, time of exposure to COVID-19, and daytime sleep dysfunction. Our data showed that parental sleep and experiences related to COVID-19 influenced sleep changes in children and adolescents. Parents had a significant difference in daytime sleepiness compared to the group without children.

Consequences of post-weaning sleep deprivation on behaviour and oxidative stress parameters in rat plasma and brain.

Sleep is essential for health: Adequate sleep is essential for healthy development and sleep deprivation results in several consequences. Indeed, sleep deprivation early in life is associated with poor behaviour and cognition, as well as impaired mental and physical health. Preclinical studies have shown that sleep deprivation alters several physiological functions later in life such as the cardiovascular, immune and endocrine systems, resulting in altered oxidative states. Most of the preclinical literature is focused on adult animals, and little is known about oxidative alterations during development, especially in the context of sleep deprivation. Hence, we adapted a classic and well-documented model of sleep deprivation, paradoxical sleep deprivation using multiple platforms, for juvenile rats and explored central and peripheral oxidative parameters, as well as the behavioural consequences of sleep deprivation post-weaning. We showed that 96 h of paradoxical sleep deprivation induced a significant reduction in body weight, decreased sucrose preference-a behaviour suggestive of anhedonia-and increased glucose and decreased cholesterol in the plasma. In the brain, we observed a decrease in reduced glutathione levels in the medial prefrontal cortex and an increase in thiobarbituric acid reactive substance levels in the hypothalamus, indicating oxidative damage in these regions. Taken together, our findings suggest that paradoxical sleep deprivation during development induces anhedonic behaviour and promotes central and peripheral alterations in oxidative parameters.

Effects of the COVID-19 pandemic on sleep quality in children and adolescents: A systematic review and meta-analysis.

We synthesise the literature on the potential influence of the COVID-19 pandemic on sleep quality in children and adolescents. The search identified studies that examined the relationship between sleep quality and disorders during the COVID-19 pandemic. It began in May 2021 and has had two updates with the last in January 2022. The databases used were LILACS, PubMed, and EMBASE. Random effects models were performed to explore heterogeneity between studies. Data were presented as continuous variables (mean value and standard deviation) to perform a meta-analysis. Twenty-nine studies from 16 countries were identified: Nine had children and eight had adolescents. The overall quality of the studies ranged from high (27.6%) to medium (65.5%) and low (6.9%). Eight studies were eligible for meta-analysis. There was an increase in sleep duration during the pandemic when compared with the previous period 0.33 (95%CI -0.07; 0.60) (p < 0.001) and late bedtime 0.78 (95%CI -0.33; 1.22) (p < 0.001). A trend toward reduced sleep efficiency was also detected 0.54 (95%CI -0.75; -0.33) p = 0.20. Parents' reports of increased use of screen media/electronic devices were associated with worse sleep quality. The results suggest an influence of the pandemic on sleep characteristics such as increased sleep duration, late bedtimes, and poor sleep quality. These alterations were related to changes in family routines during this period.

Motor and cognitive outcomes of neonates with low birth weight in Brazil: a systematic review and meta-analysis / Desfechos motores e cognitivos de recém-nascidos com baixo peso ao nascer no Brasil: uma revisão sistemática e metanálise

Abstract Background Data on the outcomes of preterm newborns in South American countries are scarce. Given the great effect of low birth weight (LBW) and/or prematurity on children's neurodevelopment, it is extremely necessary to conduct studies on these phenomena in greater depth in more heterogeneous populations such as those ones from countries with limited resources. Methods We conducted a comprehensive literature search on databases including PubMed, the Cochrane Library, and Web of Science for articles published in Portuguese and English up to March 2021 involving children born and evaluated in Brazil. The analysis of the risk of bias was adapted from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and used to evaluate the methodology of the included studies. Results From the eligible trials, 25 articles were selected for qualitative synthesis, and 5 of those, for quantitative synthesis (meta-analysis). The meta-analyses showed that children born with LBW presented lower scores on motor development when compared with controls (standardized mean difference: -1.15; 95% confidence interval [95%CI]: -1.56--0.73]; I2: 80%) and also scored lower in terms of cognitive development (standardized mean difference: -0.71; 95% CI: -0.99--0.44; I2: 67%). Conclusion The results of the present study reinforce that impaired motor and cognitive functions can be a significant long-term outcome of LBW. The lower the gestational age at delivery, the higher the risk of impairment in those domains. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database under number CRD42019112403.

Resumo Antecedentes Dados sobre desfechos de recém-nascidos prematuros em países da América do Sul são escassos. Dado o grande efeito do baixo peso ao nascer (BPN) e/ou da prematuridade no neurodesenvolvimento das crianças, é extremamente necessária a realização de estudos que investiguem esses fenômenos com maior profundidade em populações mais heterogêneas. Métodos Realizou-se uma busca da literatura em bases de dados, incluindo PubMed, Cochrane Library e Web of Science, por artigos publicados em português e inglês até março de 2021 envolvendo crianças nascidas e avaliadas no Brasil. A análise de risco de viés foi adaptada da declaração de Fortalecimento do Relato de Estudos Observacionais em Epidemiologia (Strengthening the Reporting of Observational Studies in Epidemiology, STROBE), que foi utilizada para avaliar a metodologia dos estudos. Resultados Dos estudos elegíveis, 25 artigos foram selecionados para síntese qualitativa, e 5 desses 25, para síntese quantitativa (metanálise). As metanálises mostraram que crianças nascidas com BPN apresentaram pontuação menor em desenvolvimento motor quando comparadas aos controles (diferença média padronizada, -1,15; intervalo de confiança de 95% [IC95%]: -1,56--0,73]; I2: 80%) e pontuação também menor em termos de desenvolvimento cognitivo (diferença média padronizada, -0,71; IC95%: -0,992-0,44; I2: 67%). Conclusão Os resultados deste estudo reforçam que o comprometimento das funções motoras e cognitivas pode ser um desfecho significativo de longo prazo do BPN. Quanto menor a idade gestacional no momento do parto, maior o risco de prejuízo nesses domínios. O protocolo do estudo foi registrado no banco de dados International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42019112403.

Translation and language validation of the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese.

Objective: This study aimed to translate the Epworth sleepiness scale for children and adolescents (ESS-CHAD) into Brazilian Portuguese. Material and Methods: The translation and language validation processes were carried out through translation, back translation, technical review, assessment of verbal comprehension/clarity of the scale by experts (four pediatric neurologists). After they have reached a final version of the ESS-HAD a sample of asymptomatic children and adolescents that were participants in another sleep project were invited to read and complete the questionnaire to evaluate comprehension by the aimed population. Results: Two independent researchers made the forward translation and it has around 90% of concordance. Minor disagreements were related to the position of adjectives in the sentence. No major difficulties were reported by the 3rd researcher that performed the back translation. After a consensus meeting with the four participants, we have reached a final version of the questionnaire. In the cognitive interviews, the scale was reportedly easy to understand to the 23 respondents. One adolescent suggested clarifying whether question 2 (likelihood of falling asleep watching TV or a video), referred to daytime or nighttime. The total ESS-CHAD score in this asymptomatic sample varied from 0-17, a mean score of 7.08±5.65. Discussion: The final version of the ESS-CHAD in Brazilian Portuguese was approved by the copyright owners and was well understandable by caregivers and adolescents. More studies are now necessary to use this questionnaire in a larger target population to verify its validity and internal consistency.

COVID-19 Pandemic and Autism Spectrum Disorder, Consequences to Children and Adolescents - a Systematic Review.

In this systematic review, we aimed to identify the impact of the COVID-19 pandemic on children/adolescents with a diagnosis of autism spectrum disorder (ASD). The protocol was registered on PROSPERO CRD42021255848. Articles were selected from PubMed, Embase, and LILACS according to these characteristics: patients from zero to 18 years old, exposed to the COVID-19 pandemic, impact on social communication/interaction and restricted/repetitive behavior domains. The Newcastle-Ottawa Scale was used to assess methodological quality and the risk of bias. Of the 351 articles initially identified, 26 were finally included with information on 8,610 patients. Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ASD were mostly manifested in their behavior and sleep patterns. Supplementary Information: The online version contains supplementary material available at 10.1007/s40489-022-00344-4.

Clinical profile of a cohort of neonates with seizures: Association between semiology, etiology, and electroencephalographic findings.

BACKGROUND: Seizures are the most common sign of neurologic dysfunction, reflecting a wide variety of central nervous system disorders. METHODS: A retrospective cross-sectional study of neonates with a clinical diagnosis of seizures was conducted in order to verify relationships between clinical aspects and EEG findings. Patients were divided into 3 groups according to the EEG recording available as: 1) with confirmatory ictal EEG; 2) with altered but non-ictal EEG; and 3) without any EEG recording. Variables related to pregnancy and birth history, neonatal complications, and seizure semiology (by video or clinical description) were compared to EEG findings. RESULTS: 97 neonates were included (39.1% preterm, 54.6% male), 71 with available EEG data (56.3% with ictal EEG). The group without EEG presented clinical characteristics significantly different from the others such as extreme prematurity, low birth weight, and higher neonatal mortality (P = 0.002, 0.001, and 0.003, respectively). The most common etiology was hypoxic-ischemic encephalopathy (HIE) (46.4%) followed by vascular disorders, which predominated in extremely preterm neonates (P = 0.006). Sequential seizure was the most common type (44.6%) and was more frequently identified in term neonates (46%). In 51.2% of the ictal recordings the main finding was electrographic seizure without clinical manifestation. Discharge using antiseizure medication was higher among those with ictal or altered non-ictal EEG (P < 0.001). CONCLUSIONS: HIE is still a frequently etiology for neonatal seizures. Even if the patients in the sample were not under continuous EEG, the substantial proportion of electrographic seizures without clinical manifestations detected suggests the importance of continuous EEG monitoring in neonates at increased risk of seizures.

Sleep quality among parents and their children during COVID-19 pandemic

Abstract Objective: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. Methods: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents' sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. Results: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. Conclusion: The present study's data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.

Zika virus congenital microcephaly severity classification and the association of severity with neuropsychomotor development.

BACKGROUND: Zika virus infection during pregnancy is linked to birth defects, most notably microcephaly, which is associated with neurodevelopmental delays. OBJECTIVE: The goals of the study were to propose a method for severity classification of congenital microcephaly based on neuroradiologic findings of MRI scans, and to investigate the association of severity with neuropsychomotor developmental scores. We also propose a semi-automated method for MRI-based severity classification of microcephaly. MATERIALS AND METHODS: We conducted a cross-sectional investigation of 42 infants born with congenital Zika infection. Bayley Scales of Infant and Toddler Development III (Bayley-III) developmental evaluations and MRI scans were carried out at ages 13-39 months (mean: 24.8 months; standard deviation [SD]: 5.8 months). The severity score was generated based on neuroradiologist evaluations of brain malformations. Next, we established a distribution of Zika virus-microcephaly severity score including mild, moderate and severe and investigated the association of severity with neuropsychomotor developmental scores. Finally, we propose a simplified semi-automated procedure for estimating the severity score based only on volumetric measures. RESULTS: The results showed a correlation of r=0.89 (P<0.001) between the Zika virus-microcephaly severity score and the semi-automated method. The trimester of infection did not correlate with the semi-automated method. Neuropsychomotor development correlated with the severity classification based on the radiologic readings and semi-automated method; the more severe the imaging scores, the lower the neuropsychomotor developmental scores. CONCLUSION: These severity classification methods can be used to evaluate severity of microcephaly and possible association with developmental consequences. The semi-automated methods thus provide an alternative for predicting severity of microcephaly based on only one MRI sequence.

Sleep quality among parents and their children during COVID-19 pandemic.

OBJECTIVE: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. METHODS: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents' sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. RESULTS: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. CONCLUSION: The present study's data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.

Social and environmental effects of the COVID-19 pandemic on children.

OBJECTIVE: This study aimed to review the literature, summarizing the existing evidence on the effects of the pandemic on children, adolescents and parents, with an emphasis on the psychological, emotional, and sleep quality consequences. SOURCE OF DATA: Empirical studies identified in the following databases: MEDLINE, ISI Web of Knowledge/Web of Science, and preprint servers. SYNTHESIS OF DATA: The findings point to a wide range of consequences for children and adolescents resulting from the COVID-19 pandemic, which mainly includes an increase in depressive mood symptoms. There is also an increase in anxiety symptoms, suicidal ideation, as well as potential delays in language and motor development resulting from deprivation of social interaction and the closing of schools. These effects are more severe due to previous neuropsychiatric conditions. For parents, there is an increase in anxiety, depressive and post-traumatic symptoms, which are more accentuated in those who suffered socioeconomic damage due to the pandemic. There was an important increase in situations of violence towards children by parents and caregivers during the pandemic. Also, changes in routine and fear of the pandemic have negatively impacted sleep quality, globally. CONCLUSIONS: It is noteworthy that most studies published to date used a cross-sectional design and applied online screening questionnaires. The few studies with a longitudinal design suggest that these changes may have been transitory and more prevalent at the beginning of the pandemic.

Social and environmental effects of the COVID-19 pandemic on children

Abstract Objective: This study aimed to review the literature, summarizing the existing evidence on the effects of the pandemic on children, adolescents and parents, with an emphasis on the psychological, emotional, and sleep quality consequences. Source of data: Empirical studies identified in the following databases: MEDLINE, ISI Web of Knowledge/Web of Science, and preprint servers. Synthesis of data: The findings point to a wide range of consequences for children and adolescents resulting from the COVID-19 pandemic, which mainly includes an increase in depressive mood symptoms. There is also an increase in anxiety symptoms, suicidal ideation, as well as potential delays in language and motor development resulting from deprivation of social interaction and the closing of schools. These effects are more severe due to previous neuropsychiatric conditions. For parents, there is an increase in anxiety, depressive and post-traumatic symptoms, which are more accentuated in those who suffered socioeconomic damage due to the pandemic. There was an important increase in situations of violence towards children by parents and caregivers during the pandemic. Also, changes in routine and fear of the pandemic have negatively impacted sleep quality, globally. Conclusions: It is noteworthy that most studies published to date used a cross-sectional design and applied online screening questionnaires. The few studies with a longitudinal design suggest that these changes may have been transitory and more prevalent at the beginning of the pandemic.

Effects of non-invasive respiratory support on sleep in preterm infants evaluated by actigraphy.

OBJECTIVE: Few studies have evaluated sleep in preterm infants under non-invasive ventilatory support in neonatal intensive care units (NICU). The main objective of this study was to evaluate the influence of continuous positive airway pressure (CPAP) in the sleep of premature babies. MATERIAL AND METHODS: Crossover study in a NICU. We selected preterm infants with gestational age between 28 and 37 weeks using nasal CPAP. Eighteen preterm were included. Patients were monitored with actigraphy and with the Neonatal Behavioral Assessment Scale (NBAS). RESULTS: Results showed a reduction in sleep effciency, total sleep time and total sleep period during the CPAP period when compared to the non-CPAP. NBAS demonstrated significantly greater time of deep sleep and light sleep in the period without CPAP. CONCLUSION: Our data suggests that the use of CPAP, during the first week of life, in preterm neonates, is associated with transitory alterations of sleep organization.