ABSTRACT
The international multicentre study HBSC (Health Behaviour in Schoolaged Children) conducted since 1983 in collaboration with the World Health Organization, has been adopted in our country as the national adolescent health surveillance system since 2017. The main aim is to describe and understand health-related behaviour in 11-, 13- and 15-year-olds in approximately 50 countries between Europe and North America. The study investigated different aspects, such as nutrition, risk behaviors, school and family life and social media use. In addition, the latest survey involved 17-year-old adolescents and included a section on the impact of the COVID-19 pandemic.
ABSTRACT
BACKGROUND AND AIM: Bronchiolitis is the most common lower respiratory illness in young children, mostly caused by Respiratory Syncitial Virus (RSV);PICU admission for respiratory support is required in some cases. The recent Covid-19 pandemic has altered dynamics of viral transmission in the community. We aim to describe if there has been a modification in the number and characteristics of patients admitted to Italian PICUs between the pre-pandemic and post-pandemic period. METHOD(S): Multicenter retrospective observational study based on the national electronic web-based national registry of the Italian Network of PICU Study Group (TIPNet). PICU admissions due to bronchiolitis were compared from 2017 to 2022, considering the seasonal peak periods (October, 1st to April, 30th). RESULT(S): 918 patients have been admitted due to bronchiolitis to Italian PICUs in the above mentioned years. Cumulative yearly admissions are reported in Figure 1. The winter season of 2020-2021 reported a significantly lower number of admissions. RSV was consistently the reported cause in most cases throughout the years except in season 2020-2021, when it was never reported. In the 2020-2021 season, enterovirus was reported in 23% of cases. Covid-19 as cause of bronchiolitis was reported in one case in 2020- 21 and 2 cases in 2021-22. CONCLUSION(S): Covid-19 pandemic, due to possibly multiple factors, has changed the panorama of PICU admissions due to bronchiolitis in Italy. Although research is still ongoing, it seems that Covid itself is not a cause of severe bronchiolitis requiring respiratory support. (Figure Presented).
ABSTRACT
Background The impact of the COVID-19 pandemic on adolescent suicidality is still controversial. The present systematic review and meta analysis aim to summarise findings from emerging literature about prevalences of the main suicidal outcomes among children and adolescents under 19 years old, and to compare them with the pre-pandemic period. Methods Five databases (PubMed, Embase, Scopus, CINAHL and Web of Science) were systematically searched for studies published in English from January 1st, 2020 until November 3rd, 2021, reporting prevalence for suicidal ideation (SI), suicidal behaviors (SB) and suicide (S) in the general population aged <19 during the COVID-19 pandemic. Single-study prevalence data were pooled using random-effects meta-analysis. If studies reported prevalence estimates for both pre- and during-pandemic periods, prevalence ratio (PR) comparing the two periods has been computed and pooled. Results Sixteen observational studies were selected: 10 about SI, 9 about SB and 3 about S. During the pandemic, prevalence of SI among adolescents was 21% (95% CI 12-34%) while prevalence of SB was 3% (95% CI 1-10%). Comparing pre- and during- pandemic prevalences, a significant overall increase in SB was observed (PR 1.35;95% CI 1.06-1.72) while the prevalence rates of SI remained substantially steady (PR 0.95;95% CI 0.64-1.39). A narrative review on the population-based data on suicide rates suggested an escalating trend since Summer 2020, after an initial stability of the phenomenon. Conclusions During the COVID-19 pandemic SB showed a 35% increase and suicides rates escalated after a initial stability. School closures might be involved, representing an initial protective factor for suicidality, while after the reopenings we could have assisted to a suicide rebound, especially among the most vulnerable young people. Key messages • The topic of suicidality among young people is still affected by a cultural stigma that hampers the development of both academic research, early detection and preventive policies. • The increase in suicidal behaviors among youths after the COVID-19 outbreak highlights a major public health issue that requires adequate supporting policies to control and prevent this phenomenon.
ABSTRACT
Background Over the last decade, trends of suicidality among adolescents remain unclear. We conducted a cross-sectional study using surveillance data collected over the past 10 years in the Piedmont region, Italy, to explore temporal trends in suicidality among hospitalized adolescents. Methods This was a retrospective study over an 11-year period of time. The target cohort was adolescents aged 13-19 discharged from inpatient/day-hospital care with at least one suicidality-related ICD9-CM code (i.e., suicidal ideation-SI, suicidal risk-SR and suspected suicide-SS) between 2011 and 2021 in Piedmont (Northwestern Italy). Social-economic related data is available from Census 2011. Yearly incidence rates (IR) were calculated based on the overall hospitals’ catchment population and by sex. Poisson regression model was estimated to evaluate the trend over time and the association with sex, and a potential effect of the COVID-19 pandemic. A non-linear trend was allowed by modelling natural splines. Results We included 490 adolescents (median age: 15 years, IQR: 13-16), 380 girls and 110 boys, with ICD9-CM codes for SI (264;53.9%), SR (142;29%), SS (90;18.4%) at first discharge. Girls showed a higher risk of repeated inpatient care than boys (19.2% vs 7.3%, p < 0.01). Since 2013, yearly suicidality IRs started increasing linearly in boys (+1.7/100,000 per year, 95%CI: 0.7-2.8). Apparently, suicidality IRs increasing in girls were observed since 2011 (+5.8/100,000 per year, 95%CI 2.8-8.9) and were significantly higher than in boys (p < 0.001). Conclusions Suicidality among young inpatients increased in Piedmont during the last decade. Females seemed to be more affected than males. Further research is needed to better understand gender-related risk factors for suicidality. Key messages • There has been an increase in the number of adolescents reporting suicidal ideation in the last decade, especially in girls. • Intervention strategies are urgently needed to reverse a potentially alarming trend in suicidality among young people.
ABSTRACT
Background: A novel viral infection known as COVID-19 (Coronavirus-19 disease) spread up in Wuhan (China) in December 2019, but rapidly diffused worldwide and nowadays it remains an international health problem. Because of its impact on immunologic system, immunomodulating therapies have been studied as possible treatments for severe cases of COVID-19. In that context, patients affected by from rheumatic musculoskeletal disorders (RMD) under disease modifying anti-rheumatic drugs (DMARDs) have been observed in several studies to evaluate the impact of COVID-19 on these subjects, well known to be at higher risk of infection. Objectives: The primary objective of this study is to assess prevalence and severity of COVID-19 in patients with RMD under treatment with biologic (b-DMARDs) or targeted synthetic (ts-DMARDs) DMARDs, before the vaccination campaign. The second aim is to compare those data with that in general population of the same Area (Province of Udine, Friuli Venezia Giulia Region, Italy,). Methods: A cohort of RMD patients treated with b-DMARDs or ts-DMARDs was observed from September 2019 to November 2020. Both pandemic waves have been considered, until the start of vaccination (since current variants can overcome vaccine protection), between February 2020 and April 2020 (first wave) and between September 2020 and November 2020 (second one). Results: Among 1051 RMD patients treated with b-or ts-DMARDs COVID-19 prevalence was 3.5% (37 cases) without significant differences compared to general population of the same Region (Table 1). Infected patients were 18 men and 19 women, with a median age of 60 years (IQR 49-68). Notably, the infection rate of RMD patients was significantly lower compared to the general population of the same province, particularly during the second wave (p<0.001, Table 1). Almost all patients reported fever (70%). Gastro-intestinal symptoms (nausea, vomit and diarrhoea) have been recorded in 10 subjects (27%) and resulted significantly associated with longer swab pos-itivity (p<0.05) (Figure 1). Only a small percentage of patients with COVID-19 infection was receiving corticosteroids (8%), and the doses were low (3.5 or 5 mg per day of prednisone equivalents). The most used b-DMARDs were anti-TNFs (24/37, 65%), while just 4/37 (11%) employed JAK inhibitors. A small percentage of patients (6/37, 16%) continued ongoing treatment, with no worsened outcomes, while none preventively suspended the immuno-suppressant. The course of infection was generally benign with a mortality rate of 2.6% (1 patient, with several risk factors) and only 9 patients needed to be hospitalized (24%). After COVID-19 infection, 12 subjects (32%) had RMD flare and 5 of them subsequently needed to change the immunosup-pressive drug. Conclusion: The prevalence of COVID-19 in RMD patients has been confrmed low in both waves and it could be partially explained by the great awareness about preventive strategies by the patients. The benign course of COVID-19 in our patients may be linked to the very low amount of chronic corticosteroids used and the possible protective effect of anti-TNF agents, which were the main class of biologics herein employed. Gastro-intestinal symptoms might be a predictor of viral persistence in immunosuppressed patients. This fnding could be useful to identify earlier COVID-19 carriers with uncommon symptoms (without respiratory manifestations), eventually eligible for antiviral drugs.