Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Alcohol Clin Exp Res. 2021 Sep;45(9):1853-1863. doi: 10.1111/acer.14680. Epub 2021 Sep 6.
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.
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).
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).
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.
在 COVID-19 第一波疫情期间，许多伊朗人为了避免病毒感染而误服洗手液和/或酒精饮料导致中毒。为了评估 COVID-19 大流行是否导致儿童和青少年意外接触洗手液/酒精饮料的发生率增加，我们比较了 COVID-19 期间和前一年的儿科住院率。对于 COVID-19 期间的中毒住院病例，我们还按年龄评估了病因，并评估了临床结局。
本回顾性数据关联研究评估了 2020 年 2 月 23 日至 6 月 22 日（COVID-19 期间）和 2019 年同期（参考期）期间来自九个毒理学转介中心的因酒精中毒而住院的 0 至 18 岁儿童和青少年（法定死亡报告机构）的法定医学组织（报告死亡）和住院数据。
2020 年因乙醇和甲醇暴露而住院的人数明显高于 2019 年（n=375 比 n=202；比值比[95%置信区间] 1.9 [1.6, 2.2]，p<0.001）。在 COVID-19 期间，15 岁以下患者因洗手液中毒的几率明显高于酒精饮料，而 15 至 18 岁患者因酒精饮料暴露的几率高 6.7 倍（95%CI 2.8, 16.1，p<0.001）。2020 年因饮用洗手液和酒精饮料而住院的 375 名儿童和青少年中，有 6 人死亡。15 至 18 岁患者的死亡风险是 7 倍（比值比[95%置信区间] 7.0 [2.4, 20.1]；p<0.001）。
COVID-19 第一波疫情期间伊朗的甲醇中毒事件与儿童和青少年的住院率显著增加有关，包括至少 6 名儿童因中毒住院死亡。需要提高公众对误服酒精洗手液相关风险的认识。
