Effect of Social Isolation on Families with Ill Children

Background: Parenting a child with chronic kidney disease (CKD) significantly affects mental health. Our pilot study found that family social support (FSS) is crucial for optimal care, as children with insufficient FSS had poorer kidney function at transplant referral. Parents of seriously ill children report higher levels of depression and anxiety. Perceived FSS enhances mental well-being, while environmental stress, socio-economic status (SES), and traumatic events can alter cytokine production. The isolation from the COVID-19 pandemic further amplified psychosocial stress for families. Retrospectively analysed serum samples of 23 families during the pandemic and correlated the measured serum cytokine levels with race and SES, using the Child Opportunity Index (COI) based on home addresses. Parents of sick children experience significant stress-related inflammatory changes due to a lack of FSS. Methods: A retrospective analysis of leftover blood samples from adult and pediatric participants in the "Cytokine Secretion Patterns in Pediatric COVID-19 Patients" study. Serum samples were collected in 2021. The study examined correlations between family role, race, SARS-CoV-2 status, COI, and inflammatory markers. Cytokine levels were measured using a Human Cytokine Array Kit (46-plex) from R&D Systems, Inc. Results: 54% were White (W), and 46% were Non-White (NW). No parents or siblings were infected. No significant racial differences among the sick children (18W/16AA, p=0.55) or their parents (17W/15AA, p=0.23). 65% of families lived in low SES neighborhoods. Parents from highest SES areas had the highest IL-15 and TNF-alpha levels (p=0.003 and p=0.048) (Figure 1). Linear models to examine the association between IL-15 and TNF-alpha variability and having a sick child controlled by COI regions showed a significant correlation for IL-15. Conclusion: Our study highlights stress-related inflammatory changes in parents of sick children, linked to inadequate FSS during isolation. These inflammatory responses varied significantly with SES. Ensuring sufficient FSS should be a priority.