Addressing mental health issues in immunocompromised adolescents with chronic diseases during the COVID-19 pandemic

The COVID-19 pandemic has caused a major disruption of the everyday lives of children and adolescents around the world. Although adolescents are generally not at risk of developing severe COVID-19, 1 they were heavily impacted by changes in their daily lives, including social isolation due to school clo-sures and physical distancing, decreased peer interactions, restrictions on physical activity, and increased family stress. 2,3 While social distancing measures helped contain the virus, they also caused notable adverse effects on adolescents ’ mental and physical health. Several cross-sectional 4,5 and longitudinal studies 6 based on the general adolescent population reported increased prevalence of mental illnesses during the COVID-19 pandemic, and meta-analysis of pooled data including 80.879 children and adolescents revealed that the prevalence of depression and anxiety, the two most common mental health concerns in youth, have doubled compared with pre-pandemic estimates and remained high also later in the pandemic. 7 Adolescents with preexisting chronic medical conditions were exposed to additional precipitants of psychological stress during the pandemic such as missed or delayed healthcare appoint-ments, uncertainty about the advancement of the disease, protective behaviors with quarantining, feeling of helpless-ness, and possible shortage of supplies of medicines. 8 Therefore, from a mental health perspective, it appears that they may be affected differently with the potential for a widening of existing disparities in health and developmen-tal outcomes. In ndings from a cross-sectional