Sad Commentary on Gun Violence & Drop in Biliary Atresia Cases During Pandemic

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Today.com 5/5/23: Should 3rd graders learn how to use tourniquets for school shootings? Texas bill says yes

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A Arshad et al. JPGN 2023; 76: 424-427. Reduced Presentation of Biliary Atresia During the COVID-19 Lockdown: A Population Based Observational Study

Methods: This population study assessed all confirmed cases of BA, from January 2020 to December 2021 across the 3 UK pediatric liver centers originating from England and Wales. Data was then compared to the incidence of confirmed BA cases from January to December 2017, 2018, and 2019.

Key findings -BA cases:

  • 2017: 16
  • 2018: 13
  • 2019: 18
  • 2020: 8
  • 2021: 12
  • This difference was significant in a two-sided t test for 2020 (P = 0.035) but not for 2021 (P = 0.385)

The authors note that new BA diagnoses were reduce among Danish centers as well. In their discussion, the authors discuss the possibility of missed diagnosis versus an actual drop in BA cases. The later is intriguing due to concerns that perinatal infections could trigger BA.

My take: This study provides a piece of a puzzle regarding the etiology of BA, indicating a good likelihood of environmental/infectious etiologies as a trigger.

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