Impact of the COVID-19 pandemic on care for anorexia and bulimia nervosa in US military-connected adolescents and young adults.

OBJECTIVE: This study examined the impact of the COVID-19 pandemic on healthcare engagement for anorexia nervosa (AN) and bulimia nervosa (BN) in a large, geographically diverse population. METHOD: This repeated monthly, cross-sectional study queried Military Health System records of individuals aged 10-21 before and during the pandemic (February 2019-January 2022). ICD-10 codes identified encounters for AN and BN. Monthly rates of care were modeled as the number of unique individuals with an ICD-10-identified eating disorder-related encounter per month divided by the enrolled population. Poisson regression analysis evaluated rates of care stratified by eating disorder, clinical setting, and sex. RESULTS: In a population of 1.76 million adolescents and young adults, 1629 individuals with AN or BN received care during the pre-pandemic period; 3256 received care during the pandemic. The monthly rate of care for females with AN during the pandemic increased in inpatient settings (adjusted relative risk [aRR]: 1.31 [1.16-1.49]) and outpatient settings (aRR: 1.42 [1.37-1.47]); monthly care rates in males with AN increased in the outpatient setting (aRR: 1.46 [1.28-1.67]). Females with BN had increased engagement in outpatient settings (aRR: 1.09 [1.03-1.16]); BN care for males showed no significant monthly changes during the pandemic period in either healthcare setting. DISCUSSION: With increased rates of AN and BN disorder-related care during the pandemic, screening for eating disorder symptomatology may allow for timely diagnosis and intervention in periods of heightened stress. Pandemic-related increases in healthcare engagement may strain limited resources, emphasizing a need to expand accessibility of clinical expertise. PUBLIC SIGNIFICANCE: This study indicates that monthly rates of healthcare engagement during the COVID-19 pandemic for AN and BN varied based on clinical setting and sex in an adolescent and young adult population. The increased number of individuals seeking eating disorder-related care, especially outpatient care, attributed to heightened stressors necessitates accessible professionals with eating disorder clinical expertise.

Predicting the RSV Surge: Pediatric RSV Patterns of the COVID Pandemic.

Historically, respiratory syncytial virus (RSV) infection trends have been predictable. The COVID-19 pandemic and associated precautions impacted RSV disease patterns. RSV infection trends during the first year of the COVID-19 pandemic may have predicted the 2022 surge in pediatric RSV infections. A continued emphasis on increased viral testing will allow for early recognition and preparation for future public health crises.

Opioid-Related Trends in Active Duty Service Members During the Coronavirus Disease 2019 Pandemic.

INTRODUCTION: The USA is experiencing an opioid epidemic. Active duty service members (ADSMs) are at risk for opioid use disorder (OUD). The Coronavirus disease 2019 (COVID-19) pandemic has disrupted health care and introduced additional stressors. METHODS: The Military Healthcare System Data Repository was used to evaluate changes in diagnosis of OUD, medications for OUD (MOUD), opioid overdose (OD), and opioid rescue medication. ADSMs ages 18-45 years enrolled in the Military Healthcare System between February 2019 and April 2022 were included. Joinpoint Trend Analysis Software calculated the average monthly percent change over the study period, whereas Poisson regression compared outcomes over three COVID-19 periods: Pre-lockdown (pre-COVID-19 period 0) (February 2019-February 2020), early pandemic until ADSM vaccination initiation (COVID-19 period 1 [CP1]) (March 2020-November 2020), and late pandemic post-vaccination initiation (COVID-19 period 2 [CP2]) (December 2020-April 2022). RESULTS: A total of 1.86 million eligible ADSMs received care over the study period. Diagnoses of OUD decreased 1.4% monthly, MOUD decreased 0.6% monthly, diagnoses of opioid OD did not change, and opioid rescue medication increased 8.5% monthly.Diagnoses of OUD decreased in both COVID-19 time periods: CP1 and CP2: Rate ratio (RR) = 0.74 (95% CI, 0.68-0.79) and RR = 0.72 (95% CI, 0.67-0.76), respectively. MOUD decreased in both CP1 and CP2: RR = 0.77 (95% CI, 0.68-0.88) and RR = 0.86 (95% CI, 0.78-0.96), respectively. Adjusted rates for diagnoses of opioid OD did not vary in either COVID-19 time period. Opioid rescue medication prescriptions increased in CP1 and CP2: RR = 1.09 (95% CI, 1.02-1.15) and RR = 6.02 (95% CI, 5.77-6.28), respectively. CONCLUSIONS: Rates of OUD and MOUD decreased, whereas rates of opioid rescue medication increased during the study period. Opioid OD rates did not significantly change in this study. Changes in the DoD policy may be affecting rates with greater effect than COVID-19 pandemic effects.

Mitochondrial response and resilience to anthropogenic chemicals during embryonic development.

Mitochondria are integral to maintaining cellular homeostasis. Optimum mitochondrial function is critical during embryonic development, as they play a key role in early signaling cascades and epigenetic programming, in addition to sustaining an adequate energy production. Mitochondria are sensitive targets of environmental toxins, potentially even at levels considered safe under current regulatory limits. Most mitochondrial analyses have focused only on chemical exposure effects in vitro or in isolated mitochondria. However, comparatively little is known about mitochondrial effects of chemical exposure during vertebrate embryogenesis, especially during the recovery phase following a chemical insult. Here, we used the zebrafish (Danio rerio), in a 96-well plate system, to examine mitochondrial effects of 24 chemicals including pharmaceuticals, industrial chemicals, and agrochemicals. We used oxygen consumption rate (OCR) during embryogenesis as a proxy for mitochondrial function. Embryonic OCR (eOCR) was measured in clean egg water immediately following 24 h of chemical exposure and subsequently for an additional 8 h. Each chemical, dependent upon the concentration, resulted in a unique eOCR response profile. While some eOCR effects were persistent or recoverable over time, some effects were only detected several hours after being removed from the exposure. Non-monotonic dose response effects as well as mitochondrial hormesis were also detected following exposure to some chemicals. Collectively, our study shows that mitochondrial response to chemicals are highly dynamic and warrant careful consideration when determining mitochondrial toxicity of a given chemical.