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News Scan for Aug 25, 2021

News Scan for Aug 25, 2021

Youth substance use was stable in early pandemic, study says

Substance use among US kids 10 to 14 years old remained relatively stable during the first 6 months of the pandemic, according to longitudinal study results published yesterday in the Journal of Adolescent Health.

The researchers used part of the cohort from the Adolescent Brain Cognitive Development Study and surveyed 7,842 adolescents and their families at 21 sites across the country three times during lockdown from May to August 2020. The mean age of the youth cohort was 12.4 years.

Overall, 8% reported substance use (eg, alcohol, nicotine, cannabis) in the past 30 days, with 3.4% reporting alcohol and 3.6% reporting nicotine use. Out of those who said they had used substances in the past month, 72% said they used any substance 1 to 2 days in that time and 76% used only one substance.

In a 1,079-youth subset comparing a survey from September 2019 to January 2020 with the first pandemic survey in May and June 2020, alcohol use decreased from 1.9% to 0.7% while use for nicotine and misuse of prescription drugs increased (0% to 1.5% and 0% to 0.7%, respectively). The researchers say these changes could be due to which substances are easier to use in secrecy during lockdown.

Substance use was more likely in youth who were experiencing anxiety, depression, or stress, and youth who had extreme stress about the pandemic’s uncertainty were 2.37 times more likely to use than those who were slightly stressed. Likelihood also increased when families were experiencing loss of income or material hardship (1.23 times and 1.39 times, respectively).

“Taken together, these findings underscore the disproportionate burden of the pandemic on youth and families with pre-existing disadvantages,” said first author William Pelham III, PhD, in a University of California–San Diego (UCSD) press release. “Providing material support to distressed families and linking emotionally distressed youth to support may serve as important risk-mitigation strategies, both today and during similar events in the future.”
Aug 24 J Adolesc Health study
Aug 24 UCSD
press release


Lyme rates appeared to drop in 2020, but cases might have been missed

Despite Americans spending more time outside in 2020, there were fewer tick bite–related emergency department (ED) visits and Lyme disease lab tests, but the trend might be an artifact of COVID-19, according to an Emerging Infectious Diseases research letter yesterday.

The researchers pieced together data from a 4,103-person survey, Centers for Disease Control and Prevention (CDC) website traffic, National Syndromic Surveillance Program BioSense, and one independent clinical lab.

About 50% of survey respondents from Jul 31 to Aug 9, 2020, said they spent more time outside than in previous years, and the CDC’s website page describing tick removal had about 25% more visits (818,167) in 2020 than in 2018 and 2019. However, ED visits decreased in both total number and rate per 100,000 visits.

The largest difference was in May: In May 2017 to 2019, 12,693 ED visits occurred and the prevalence was 145 per 100,000 visits, but in May 2020, visits dropped to 5,845 and prevalence declined to 89 per 100,000 visits. Lyme disease volume testing decreased by 25% from 2019 to 2020, with test positivity declining slightly, to less than 1%. 

“Despite ongoing exposure, Lyme disease case reporting for 2020 might be artificially reduced due to coronavirus disease–associated changes in healthcare-seeking behavior,” the authors concluded. “Decreased reporting also could render 2020 inconsistent with long-term trends and changes in the epidemiology of the disease.”
Aug 23 Emerg Infect Dis study

Study shows racial minorities more likely to be hospitalized for flu

A study yesterday in JAMA Network Open spotlights racial disparities in patients with severe flu over 10 US flu seasons, with Black, Hispanic, and American Indians or Alaska Natives hospitalized and admitted to the intensive care unit (ICU) more often than their White counterparts after adjusting for age.

The cross-sectional study was based on data collected from the Influenza-Associated Hospitalization Surveillance Network, and included 113,352 patients with an flu-associated hospitalization from 2009 to 2019. Main study outcomes were hospitalization, ICU admission, and in-hospital death.

Very few differences in outcomes were observed in patients ages 75 and older, but racial disparities were evident in those 64 and younger.

Persons aged 50 to 64 with severe flu requiring hospitalization were more likely to be Black (RR 2.50; 95% confidence interval [CI], 2.43-2.57)), and Black patients were also more likely to be admitted to the ICU (RR, 2.09; 95% CI, 1.96-2.23). For patients under 50, American Indian or Alaska Native persons were more likely to be hospitalized than their White peers (RR, 1.72; 95% CI, 1.51-1.96) and to be admitted to an ICU (RR, 1.84; 95% CI, 1.40-2.42).

Differences in rates of hospitalization, ICU admission, and in-hospital deaths by race and ethnicity were greatest among children aged 4 years or younger, the authors found. “Black, Hispanic, and Asian or Pacific Islander children had 3- to 4-fold the rate of in-hospital death compared with White children,” they wrote.
Aug 24 JAMA Netw Open study

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