Impact of the Coronavirus Disease 2019 Pandemic on Clinical Trends in Pediatric Intentional Self-Poisonings

During the coronavirus disease 2019 pandemic, there was a significant increase in pediatric emergency department visits and hospital admissions for suicidality and self-harm, including deliberate self-poisoning. This study compares demographics, clinical characteristics, management, and outcome data of pediatric patients with intentional self-poisonings before and during the pandemic. A secondary aim is to identify predictors of severe outcomes.

De-identified data were retrieved from the Toxicology Investigators Consortium registry of patients ages 6 to 18 years presenting with intentional self-poisoning. χ 2 analyses and Fisher exact test were performed to determine associations among variables between the "pre-pandemic" (April 2017 to February 2020) and "pandemic" (March 2020 to October 2022) periods, with P value <0.05 considered statistically significant. Multivariable logistic regression analysis was conducted to explore correlates of severe outcomes.

There were 7034 cases identified, 3480 pre-pandemic and 3604 pandemic. The pandemic group was associated with a higher percentage of patients aged 7 to 12 years, patients identifying as transgender or gender non-conforming, and the use of non-opioid analgesics as a primary agent. The pre-pandemic group had more frequent polysubstance ingestions and severe outcomes. Subgroup analysis of severe outcomes showed few differences between pre-pandemic and pandemic groups. No demographic characteristics were strongly associated with severe outcomes.

The demographic differences between time periods suggest the pandemic may have had a disparate impact on these vulnerable populations. Identifying trends in pediatric self-poisonings may help guide public health strategies and resources for prevention and harm reduction.