Medical Toxicology and COVID-19: Our Role in a Pandemic

Neumann, Natalie; Chai, Peter R.; Wood, David M.; Greller, Howard A.; Mycyk, Mark B.

doi:10.1007/s13181-020-00778-4

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…Neumann, et al mentioned a decrease in the number of poisoned cases during lockdown, but predicted that with lockdowns and pandemic progression, the suicidal rates might increase due to the resultant depressions. 55 Suicidal use of pesticides accounts for around one-third of the world's suicides, with developing countries accounting for a major portion. 56 Furthermore, pesticide poisoning comes in the second rank of suicides in the Eastern Mediterranean regions.…”

Section: Discussionmentioning

confidence: 99%

Impact of Lockdown due to COVID-19 on the Modalities of Intoxicated Patients Presenting to the Emergency Room

Fayed

Sharif

2021

Prehosp. Disaster med.

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Introduction: Coronavirus disease 2019 (COVID-19) pandemic influences health care facilities world-wide. The flow rate, type, and severity of cases presented to emergency departments varied during the pandemic in comparison to the past years. However, this change has not been well-described among the cases of hospital admission due to toxic exposure. Study Objective: Recognition of the pattern of toxic exposure among the cases refereed to Tanta Poison Control Center (TPCC; Tanta, Egypt) during the past five years, and furthermore, exploration of the impact of lockdown due to the COVID-19 pandemic on the pattern of presented cases. Methods: The current study is a five-year retrospective, comparative cross-sectional study carried out among acutely intoxicated patients admitted to TPCC during the spring months (March through May) of 2016-2020. A total of 1,916 patients with complete medical records were recruited. The type and manner of toxic exposure, demographic, clinical data, and outcomes were analyzed. Results: The current study noted that there were delays in time from toxic exposure to emergency services during the lockdown period. This was reflected in significant lower recovery rates (884.8/1,000 population; z = −3.0) and higher death rates (49.4/1,000 population; z = 2.1) despite the marked decrease in the total number of hospital admissions in comparison to the past four years. The lockdown period showed significantly higher phosphides (z = 3.5; χ2 = 34.295; P <.001) and antipsychotics exposure (z = 3.6; χ2 = 21.494; P <.001) than the previous years. However, predominance of female exposure and intentional self-poisoning was maintained over the past five years, including the lockdown. Conclusion: COVID-19-associated lockdown greatly reformed the usual intoxication pattern of the cases admitted to emergency room. Also, it played a role in delaying time of hospital arrival, which was reflected as lower recovery rates and higher death rates.

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Section: Discussionmentioning

confidence: 99%

Impact of Lockdown due to COVID-19 on the Modalities of Intoxicated Patients Presenting to the Emergency Room

Fayed

Sharif

2021

Prehosp. Disaster med.

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“…Indeed, COVID-19 posed new challenges also in the pharmacological management of patients already on medications for one or more underlying pathologies [ 14 , 15 ]. Clinicians could therefore take advantage of PCCs knowledge and access to specific databases for potential drug–drug interactions and toxicity of new and old medications [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

How COVID-19 Lockdown in Italy Has Affected Type of Calls and Management of Toxic Exposures: a Retrospective Analysis of a Poison Control Center Database From March 2020 to May 2020

et al. 2021

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Introduction Between early March 2020 and the end of May 2020, Italy issued strict measures to limit further spread of coronavirus disease 2019 (COVID-19) and became the first European country that imposed a lockdown on the population. The aim of this study was to assess the impact of these restricted conditions on the activity of the Poison Control Center (PCC) of Policlinico Umberto I Hospital-Sapienza University of Rome. Methods This was a retrospective analysis of calls received by the PCC during the lockdown period March 9, 2020 through May 31, 2020 compared to the same time period in year 2019 (reference). Results We observed a reduction in calls from hospitals and emergency departments and an increase in calls from private citizens about exposures to products or intoxications during the lockdown. There were increases in unintentional exposures and exposures to hand and surface sanitizers among household and cleaning products. There was a decrease in calls concerning medications, which were mostly from hospitals and emergency departments. We observed increases in exposures requiring clinical observations among adults and referral to the emergency department among pre-school children. Conclusions Public health protection measures against COVID-19 to improve hygiene and maintain clean environments can increase exposures to hazardous products in the domestic environment. We observed an increase in unintentional exposures to household and cleaning products during the lockdown and an increase in ED referrals for pre-school children compared to the previous year. Our data suggest the need for improvements in public campaigns that promote safer handling of household products and prevent unnecessary exposures during a lockdown. The public health promotion activity can benefit the community after the pandemic and prepare the community for lockdowns in the future.

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“…In line with our results, researchers in Europe noted a precipitous decline in the number of ingestions receded since the national and regional lockdowns were instituted. 25,26 Other studies found that although suicide rates may have decreased temporarily, longer periods of social isolation could lead to the deterioration of the mental health of citizens, resulting in an increase in overdoses. 27-29…”

Section: Discussionmentioning

confidence: 99%

Toxicology Practice During COVID-19 Pandemic: Experience of the Dammam Poison Control Center-Eastern Province, Saudi Arabia

2021

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Background: The sudden emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and scarcity of the accurate information especially in the initial phase of the struggle presented a series of challenges to health systems. Objective: To evaluate the changes in poisoning cases regarding distribution, types, and characteristics for better framing and planning of the role of our field in responding to pandemics. Methods: Study of telephone consultation calls and toxicology analysis records of poisoning cases referred to the Dammam Poison Control Center in Saudi Arabia during the first half of 2020. Their distribution according to frequencies, causes, and other characteristics was compared to the first half of 2019. Results: Analysis of telephone consultation calls revealed that the proportion of exposure to disinfectants and hand sanitizers during first half of 2020 increased to 20.4% (n = 496) and 3.4% (n = 83), respectively, compared to 9.8% (n = 215) and 0.4% (n = 10) for surface disinfectants and hand sanitizers, respectively, during the first half of 2019. In 2020, exposure to disinfectants and hand sanitizers dominated in preschool children (0-5 years). The total number of cases suspected for drugs/drugs of abuse overdose during the first 6 months of 2020 (n = 783) showed a significant decrease (P < 0.001) compared to the first 6 months of 2019 (n = 1086). Conclusion: The increased availability and use of disinfectants and sanitizers significantly increased the risk of poisoning, especially in preschool-aged children. Public health education for prevention of such home exposures is urgently needed to avoid unnecessary emergency medical system use in such critical time.

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Medical Toxicology and COVID-19: Our Role in a Pandemic

Cited by 18 publications

References 22 publications

Impact of Lockdown due to COVID-19 on the Modalities of Intoxicated Patients Presenting to the Emergency Room

Impact of Lockdown due to COVID-19 on the Modalities of Intoxicated Patients Presenting to the Emergency Room

How COVID-19 Lockdown in Italy Has Affected Type of Calls and Management of Toxic Exposures: a Retrospective Analysis of a Poison Control Center Database From March 2020 to May 2020

Toxicology Practice During COVID-19 Pandemic: Experience of the Dammam Poison Control Center-Eastern Province, Saudi Arabia

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