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Fewer kids’ ED visits amid COVID, but more mental healthcare in teen girls

Lower percentages of US children visited an emergency department (ED) for any indication amid the COVID-19 pandemic, while adolescent girls accounted for the largest hikes in visits for mental illness, according to two Centers for Disease Control and Prevention (CDC) studies published late last week in Morbidity and Mortality Weekly Report (MMWR).

For both studies, the researchers mined pediatric ED visit data in the National Syndromic Surveillance Program for three periods: Mar 15, 2020, to Jan 2, 2021; Jan 3, 2021, to Jan 1, 2022; and Jan 2 to 29, 2022, compared with the same periods in 2019.

The first study found that, relative to 2019, overall ED visits by children 17 years and younger in 2020, 2021, and January 2022 fell by 51%, 22%, and 23%, respectively. COVID-19 visits made up the biggest proportion of ED visits among all ages, while visits for other respiratory diseases largely declined.

At the same time, the number and percentage of visits for some injuries (eg, guns, self-harm, drugs), chronic illnesses, and mental health concerns rose but varied by age-group.

The findings point to the need for vigilance for indirect effects of the pandemic on children’s and adolescents’ health, including problems resulting from delayed care and increasing stress and mental health concerns—particularly among older children and adolescents, the study authors said.

“Prevention programs that improve children and adolescents’ physical and mental health are critical during and after emergencies,” the researchers wrote. “Reducing COVID-19 infection through vaccination and other nonpharmaceutical prevention strategies can further protect pediatric health.”

The second study found that, compared with 2019, weekly ED visits among girls 12 to 17 years old rose for eating and tic disorders in 2020; depression, eating, tic, and obsessive-compulsive disorders in 2021; and anxiety, trauma- and stress-related, eating, tic, and obsessive-compulsive disorders in 2022. Over the same period, mental health–related ED visits declined for adolescent boys.

The authors called for evidence-based primary prevention, early identification, and treatment strategies that support children’s physical and mental health, especially for adolescent girls.

“CDC supports efforts to promote the emotional well-being of children and adolescents and provides resources for clinicians, families, schools, and communities,” they concluded.
Feb 18 MMWR pediatric study and mental health study

Family members suffer PTSD after COVID-19 ICU stay, study reveals

A new study from French researchers shows that family members of patients hospitalized in the intensive care unit (ICU) with COVID-19 acute respiratory distress syndrome (ARDS), as compared with other causes of ARDS, were at a significantly increased risk of symptoms of post-traumatic stress disorder (PTSD) at 90 days after ICU discharge.

The study was published in JAMA late last week.

The prospective study included patients seen in 23 ICUs in France from January of 2020 to June of 2020, with final follow-up ending in October of that year.

Researchers analyzed data on 517 families of ICU patients. Thirty-five percent of families with a member diagnosed as having COVID-19 ARDS reported PTSD within 3 months of hospital discharge, compared to 19% among families of patients with non-COVID ARDS.

Family members of COVID-19 patients reported more anxiety and depression, which may be attributed to the isolation family members felt as they were not allowed inside hospitals during the first part of the pandemic, the authors suggested.

“This study extends prior findings to show that the level of social support was associated with PTSD symptoms. There are many potential explanations for these findings including the need to comply with strict isolation measures to prevent viral transmission and the strain put on ICU staff due to the surge in patient numbers caused by the pandemic,” the authors said.
Feb 18 JAMA study

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