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Social distancing – this is the formula to which pandemic daily life has had to adapt to in a very short time. In the public debate, however, it is often overlooked that this is not only a contemporary phenomenon. This article expands the discussion to include an historical perspective on social distancing, by focusing on scenes of hygiene and disease prevention from the 18th and 19th century. It becomes evident that socially distanced behaviors practiced during times with increased risks of infection is not just a product of medical progress, but is modelled on the growing middle-class lifestyle. © Leviathan (Germany). All rights reserved.
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Background: Since April 2020, some high schools were closed to in-person teaching, and interscholastic and club sports were cancelled in an attempt to slow the spread of COVID- 19. While some US adolescents participated in sports since April 2020, other US adolescents did not participate in sports during this time. It is unknown what effect sport participation has had on the health of adolescents. Hypothesis/Purpose: To identify how sport participation during the COVID-19 pandemic impacted the health of adolescents. Methods: Adolescents across the US were recruited via social media to complete an online survey in the spring of 2021. Participants were asked to report their demographics (age, gender, race), whether they participated in school club or school sports since May 2020, type of school they attended (in-person, online, hybrid), and measures of mental health (MH), physical activity (PA) and quality of life (QoL). Assessments included the: General Anxiety Disorder-7 Item (GAD-7) for anxiety, Patient Health Questionnaire-9 Item (PHQ-9) for depression, Pediatric Functional Activity Brief Scale (PFABS) for physical activity, and Pediatric Quality of Life Inventory 4.0 (PedsQL) for quality of life. Assessment scores were compared for respondents who participated in sports (PAR) with those that did not participate in sports (NoPAR). Univariable comparisons between the groups were made via ttests or chi-square tests while means for continuous outcome measures were compared between the groups by ANOVA models that controlled for age, gender, race and the type of school attendance. Results: 4,693 adolescents (52% female, Age = 16.1+1.3 yrs., grades 9-12) from 38 states participated in the study with PAR = 4,286 (91%) and NoPAR = 407 (9%). NoPAR participants reported a higher prevalence of moderate to severe levels of anxiety (29.3% vs 21.3%, p<0.001) and depression (40.7% vs 19.8%, p<0.001). NoPAR participants reported lower (worse) PFABS scores (mean 13.2 [95%CI 12.4, 13.9] vs 21.2 [20.7, 21.6] p<0.001) and lower (worse) PedsQL total scores compared to the PAR group (77.9 [76.5, 79.3] vs. 83.2 [82.3, 84.1], p<0.001). Conclusions: Adolescents who did not play a sport during the COVID-19 pandemic reported significantly higher levels of anxiety and depression, as well as lower physical activity and quality of life scores compared to adolescents who did play a school or club sport. Participation in organized sports may offer an important opportunity to improve physical activity and mental health for adolescents during and after the COVID-19 pandemic.
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Background: In young adults and adolescent males, myocarditis has been described as a rare complication of SARS-CoV-2 mRNA-vaccination. Reported findings include chest pain, elevated troponin levels, and cardiac MRI abnormalities. ECG abnormalities include ST-elevation but to our knowledge, ventricular arrhythmia has not been yet described. In the vast majority of reported cases, symptoms were relatively mild and patients recovered fully. Method: Here, we report two male adolescents (15 resp. 13 years old) admitted to our hospital with nonsustained (ns) VT and chest pain (patient no. 1) and near syncope (patient no. 2) after receiving an mRNA-SARS-CoV-2 vaccine (patient no. 1: 4 days after the second dose and patient no. 2: 15 days after days after the first dose). Further workup included family history, standard 12 lead ECG, the Holter monitoring, heart catheterization, myocardial biopsy, invasive programmed RV stimulation, and cardiac MRI. Results: Both patients did not have elevated troponin levels nor specific ECG findings. Family history was free for cardiac diseases, sudden cardiac death, or syncopal episodes. The Holter monitoring showed recurrent ns VT in one patient. Cardiac MRI and myocardial biopsy in both patients did not show evidence of myocarditis, but both patients showed severe thickening of the arterioles in myocardial biopsy. Invasive RV-stimulation did not trigger VT. Ultimately, both patients did not meet diagnostic criteria for myocarditis and β-blockers were started for ns VT. As of today, four more patients in age group 12 to 17 years were diagnosed with vaccine-associated myocarditis in our institution and one male with COVID-19 associated myocarditis. Notably, none of these patients had ventricular tachycardia or other cardiac arrhythmia. Conclusion: We observed ventricular tachycardia after SARS-CoV-2-mRNA vaccination in two adolescent males. This manifestation seems to be distinct from the well-described vaccine-associated myocarditis. Interestingly in both patients, perivascular thickening of arterioles was noted in biopsy. The mechanism and causality of ventricular arrhythmia in association with SARS-CoV-2 mRNA vaccines remain unclear and requires further observation.