BACKGROUND AND OBJECTIVES The worldwide SARS-CoV-2 virus pandemic challenges adolescents’ mental health. The aim of this study was to compare the number of pediatric intensive care unit (PICU) admissions after suicide attempts during the first German lockdown and one year later during a second, prolonged lockdown with pre-pandemic years. METHODS A retrospective multicenter study was conducted among 27 German PICUs. Cases <18 years admitted to the PICU due to accidents or injuries between March 16th and May 31st of 2017-2021 were identified based on ICD-10 codes (German modification) and patient data entered into a database. This study is a subset analysis on suicide attempts in adolescents aged 12–17.9 years. The Federal Statistics Office was queried for data on fatal suicides, which were available only for 2020 in adolescents aged 10–17.9 years. RESULTS Total admissions and suicide attempts declined during the first lockdown in 2020 (standardized morbidity ratio (SMR) 0.74 (95% CI 0.58–0.92) and 0.69 (0.43–1.04), respectively) and increased in 2021 (2.14 (SMR 1.86–2.45) and 2.84 (2.29–3.49), respectively). Fatal suicide rates remained stable between 2017–2019 and 2020 (1.57 v. 1.48/100,000 adolescent years) with monthly numbers showing no clear trend during the course of 2020. CONCLUSIONS This study shows a strong increase in serious suicide attempts among adolescents during the course of the pandemic in Germany. More research is needed to understand the relation between pandemic prevention measures and suicidal ideation to help implement mental health support for adolescents.

Priapism is defined as prolonged and persistent erection of the penis without sexual stimulation. It is associated with excessive hyperleukocytosis (e.g. in acute or chronic leukaemia); however, this complication is rarely seen in the pediatric population. We report a 12-year-old boy suffering from acute leukaemia presenting with, at first intermittent, but increasingly persistent erection. Doppler US revealed signs of high-flow priapism. MRI excluded intrapelvic tumour masses, and three-dimensional contrast-enhanced MR angiography could not demonstrate an arteriovenous fistula or thrombosis. Cavernosal blood-gas measurement was in agreement with high-flow priapism. On the basis of the imaging findings, invasive therapeutic management was avoided in our patient with a successful outcome.

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