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The number of AN cases also rose with the pandemic.
In Canada, the COVID-19 epidemic has been linked to a spike in cases of AN among children and adolescents. As reported in other areas, there have been increases in both ER visits (Toulany A, et al. J Adolesc Health. 2022. 70:42) and hospitalizations (Vyer E et al. J Adolesc Health. 2022. S: 1054-139X). These increases were also reported in an ongoing study by Debra Katzman, MD, professor of pediatrics at the Hospital for Sick Children in Toronto and the University of Toronto. From September 1 to December 31, 2021, Dr. Katzman and colleagues saw 118 first-time hospitalizations for persons with AN. Among these patients, more than 90% were female, and 66% of cases occurred among teens 14 to 17 years of age. The remainder occurred in teens aged 11 to 13. In 49% of the cases, the reporting physicians identified the pandemic as a precipitating factor in AN onset, and in more than one third of the AN-related hospitalizations (Medscape. September 28, 2022).
The authors reported familiar reasons for the spike in cases: disruptions in daily routines, closure of schools and cancellation of recreational activities, loss of regular connections with friends, and loss of extracurricular and social activities. All these factors led to increased anxiety and depression and a feeling of lack of control. Compounding this were closure of outpatient facilities, long waiting lists to get into facilities that were open, and fear of the virus when going to medical offices and to emergency departments.
Anxiety and depression were present for older teens, adolescents, and preteens alike. The average age for these diagnoses among pediatric patients in Canada fell from 16 to 15 years, and the youngest age at diagnosis declined from 12 to 11 years.