ingestion is unfortunately common, but the impact of COVID-19 pandemic has created an alarming upsurge in this practice of self-harm 8,9 . There is a paucity of available data in this regard. Various media reports echo the upsetting revelations of mounting trends in poison ingestion. These reports need an urgent interpretation.LMICs with an already fragile healthcare infrastructure are highly vulnerable to health crises while dealing with pandemics like COVID-19. Moreover, in many critical care settings, clinicians and ICU staff are not adequately trained to assess mental healthcare. The present hospital-based study is designed to highlight the burden on the medical intensive care units (ICUs) due to self-ingestion of poison during the COVID-19 pandemic. Research from various settings, such as ICUs, highlighting suicidal trends, demographic features, and mortality during an ongoing pandemic is crucial to developing collaborative efforts at the global level to combat mental health threats 10 .
METHODSAfter the approval of the ethical review board, this retrospective review of medical records was conducted at the medical ICU of a tertiary care hospital in Karachi during the COVID-19 pandemic years 2020-2021. All patients aged ≥14 years who were admitted to the medical ICU for deliberate self-ingestion of poison were included. The demographic features and outcomes of admissions with deliberate poisoning during the 1 March 2020-28 February 2021 (COVID-19 pandemic period) were compared with the same period in March 2019-February 2020 (pre-COVID-19 period). Data regarding number of admissions, age, sex, marital status, employment status, history of any psychiatric illness, length of ICU stay, APACHE score, need for mechanical ventilation, and outcome (discharge, or death), were collected. These were used to compare self-ingestion of poison during lockdown (18 March-30 July 2020) and post-lockdown (1 August-31 December 2020). Associated risk factors for suicide were also examined.
Statistical analysisData were analyzed using the statistical software STATA (version 14.2). For continuous variables, mean and standard deviation (SD) are reported, whereas for qualitative variables, frequencies and percentages are given. The comparison between the COVID-19 and pre-COVID-19 periods was assessed using the chi-squared test or Fisher's exact test (for qualitative variables). An independent t-test was used to evaluate the difference after assessing normality, with statistical significance set at p<0.05.
RESULTSAmong 915 all-cause admissions during the COVID-19 pandemic period, 217 (23.7%) were admitted to the medical ICU with deliberate ingestion of poison. In comparison, 120 (n=1107; 10.84%) admitted with the same intention in the pre-COVID-19 era (Table 1). The mean age of patients during the pandemic and pre-pandemic periods was 27.25 (SD=9.86) and 25.97 years (SD=9.23), respectively (p=0.244). The age group 14-25 years (n=112; 51.6%) was the most vulnerable group during both periods (p=0.584). Similarly, a greater percentage o...