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Covid-19 Pandemic and Methanol Poisoning Outbreak in Iranian Children and Adolescents: A Data Linkage Study Publisher Pubmed



Mahdavi SA1 ; Kolahi AA2 ; Akhgari M1 ; Gheshlaghi F3 ; Gholami N4 ; Moshiri M5 ; Mohtasham N6 ; Ebrahimi S7 ; Ziaeefar P7 ; Mcdonald R8 ; Tas B8 ; Kazemifar AM9 ; Amirabadizadeh A10 ; Ghadirzadeh M1 Show All Authors
Authors
  1. Mahdavi SA1
  2. Kolahi AA2
  3. Akhgari M1
  4. Gheshlaghi F3
  5. Gholami N4
  6. Moshiri M5
  7. Mohtasham N6
  8. Ebrahimi S7
  9. Ziaeefar P7
  10. Mcdonald R8
  11. Tas B8
  12. Kazemifar AM9
  13. Amirabadizadeh A10
  14. Ghadirzadeh M1
  15. Jamshidi F11
  16. Dadpour B5
  17. Mirtorabi SD1
  18. Farnaghi F4
  19. Zamani N2, 12
  20. Hassanianmoghaddam H2, 12
Show Affiliations
Authors Affiliations
  1. 1. Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
  2. 2. Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Department of Pediatrics, School of Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
  6. 6. Department of Pediatric Clinical Toxicology, Abuzar’s Children Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  7. 7. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  8. 8. National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
  9. 9. Department of Internal Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
  10. 10. Cardiovascular Disease Research Center, Birjand University of Medical Sciences, South Khorasan, Iran
  11. 11. Department of Forensic Medicine and Social Determinant of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  12. 12. Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Alcoholism: Clinical and Experimental Research Published:2021


Abstract

Background: During the first wave of COVID-19, many Iranians were poisoned by ingesting hand sanitizers and/or alcoholic beverages to avoid viral infection. To assess whether the COVID-19 pandemic resulted in an increased prevalence of accidental hand sanitizer/alcoholic beverage exposure in children and adolescents, we compared pediatric hospitalization rates during COVID-19 and the previous year. For poisoning admissions during COVID-19, we also evaluated the cause by age and clinical outcomes. Methods: This retrospective data linkage study evaluated data from the Legal Medicine Organization (reporting mortalities) and hospitalization data from nine toxicology referral centers for alcohol-poisoned patients (age 0 to 18 years) for the study period (February 23 to June 22, 2020) and the pre-COVID-19 reference period (same dates in 2019). Results: Hospitalization rates due to ethanol and methanol exposure were significantly higher in 2020 (n = 375) than 2019 (n = 202; OR [95% CI] 1.9 [1.6, 2.2], p < 0.001). During COVID-19, in patients ≤15 years, the odds of intoxication from hand sanitizers were significantly higher than from alcoholic beverages, while in 15- to 18-year-olds, alcoholic beverage exposure was 6.7 times more common (95% CI 2.8, 16.1, p < 0.001). Of 375 children/adolescents hospitalized for alcoholic beverage and hand sanitizer exposure in 2020, six did not survive. The odds of fatal outcome were seven times higher in 15- to 18-year-olds (OR (95% CI) 7.0 (2.4, 20.1); p < 0.001). Conclusion: The Iranian methanol poisoning outbreak during the first wave of COVID-19 was associated with significantly increased hospitalization rates among children and adolescents—including at least six pediatric in-hospital deaths from poisoning. Public awareness needs to be raised of the risks associated with ingesting alcoholic hand sanitizers. © 2021 Research Society on Alcoholism
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