Abstract
OBJECTIVE: This study examined the association between COVID-19 and the risk of self-harm, suicidal ideation and poisoning in school-aged children and adolescents. MATERIALS AND METHODS: We utilized the 2019-2021 Utah All Payers Claims Database (APCD) to identify school-age children and adolescents aged 6-15 years in 2019. COVID-19 diagnosis, self-harm, suicidal ideation and poisoning were identified using ICD-10 diagnosis codes. Baseline characteristics were assessed, and Inverse Probability Weighting (IPW) was applied to balance these characteristics between the two groups (those with COVID-19 and those without). Weighted logistic regression was employed to identify factors associated with these outcomes in 2021. RESULTS: The study included 180,925 participants (48% female; mean [SD] age in 2019: 10.6 [2.9] years), of whom 45,056 (24.9%) had a COVID-19 in 2020, and 51.5% were aged 11-15 years. Subjects with COVID-19 had twice the odds of suicidal ideation (AOR = 2.00, p < 0.01) and more than twice the odds of self-harm (AOR = 2.05, p < 0.01) and poisoning (AOR = 2.21, p < 0.01) compared to those without COVID-19. Adolescents aged 11-15 years had nearly four times the odds of suicidal ideation compared to those aged 6-10 years (AOR = 3.97, p < 0.01) while female participants were significantly more likely to engage in self-harm than male participants (AOR = 1.73, p < 0.01). CONCLUSION: Our findings suggest a significant association between diagnosed COVID-19 and self-harming behaviours in children and adolescents.