Anorexia cases, hospitalizations rose in Canadian youth during COVID-19
A study of 1,883 Canadian children and teens with newly diagnosed or atypical anorexia nervosa shows that rates of the disease rose 66%, and hospitalizations climbed 267%, per month during the first 9 months of the COVID-19 pandemic.
The study, published yesterday in JAMA Network Open, also showed that in the same period, illness onset was faster, and the disease was more severe by the time patients sought care than before the pandemic.
Researchers at Montreal Children's Hospital analyzed eating disorder assessments conducted with patients 9 to 18 years old within 7 days of a new or atypical anorexia diagnosis at six pediatric hospitals in Canada from Mar 1 to Nov 30, 2020. They compared anorexia rates from that period with those from Jan 1, 2015, to Feb 28, 2020, before the pandemic. Median patient age was 15.9 years, and 91% were girls.
Before the pandemic, new or atypical anorexia case rates were stable, at an average of 24.5 cases per month. During the pandemic, new anorexia diagnoses increased to, on average, 40.6 cases per month, and hospitalizations rose from an average of 7.5 to 20.0 per month.
Trends were most pronounced in provinces with higher COVID-19 rates and thus more stringent lockdowns and healthcare closures.
Markers of disease severity were worse among patients diagnosed as having anorexia during the pandemic than before, with faster disease progression (7.0 vs 9.8 months), greater average weight loss (19.2% vs 17.5%), and worse bradycardia (abnormally slow heartbeat) (average, 57 vs 63 beats per minute).
The researchers said that the cause for the uptick in anorexia cases and hospitalizations is likely multifaceted, citing school closures, lack of structures that normalize eating, social isolation, lack of physical activity, and increased social media use. "These findings highlight the need for expanded eating disorder and mental health programs during and after the COVID-19 pandemic," they wrote.
In a commentary in the same journal, Youngjung Kim, MD, PhD, of Massachusetts General Hospital, called for research into a possible connection between anorexia symptom severity and previous COVID-19 infection. "It is unknown whether any viral contributions can be found in the pathogenesis of anorexia nervosa, and future investigations could enhance the understanding of the biological processes of anorexia nervosa," she wrote.
Dec 7 JAMA Netw Open study and commentary
Rhode Island confirms its first Jamestown Canyon virus case in 8 years
Rhode Island has confirmed its first case of Jamestown Canyon virus infection since 2013, according to a Dec 6 news release.
The Rhode Island Department of Health (RIDOH) said a person from Kent County in his or her 50s tested positive for the mosquito-borne disease. Symptoms first developed in September and led to hospitalization.
Because of symptom progression, the medical team submitted samples to the Centers for Disease Control and Prevention (CDC) in mid-October, and the CDC confirmed Jamestown Canyon virus. The patient has since been discharged from the hospital and is recovering, the RIDOH said.
Jamestown Canyon virus circulates widely in North America, primarily between deer and mosquitoes, but it can also infect people. Human cases can occur from late spring through mid-fall, according to the news release. People can be infected and develop no or only mild symptoms. Early symptoms can include fever, muscle aches, headaches, and fatigue. Rarely, more serious central nervous system disease, including meningitis or encephalitis, can occur.
The RIDOH also reported its second West Nile virus case of the year. Connecticut has confirmed 6 West Nile cases in people this year, and Massachusetts has reported 10.
Dec 6 RIDOH news release