Evidence map›Paper›PMID 41705545›Full record

ArticleClinical toxicology (Philadelphia, Pa.)2026

Intentional pediatric nonprescription cold/cough and analgesic/antipyretic exposure trends amid the COVID-19 pandemic.

Sara Karami, Christian Angelo I Ventura, Ellen Pinnow, Ibrahim Ibrahim, Dorothy Chang, Ajoa Asonye, Lynda McCulley, Tamra Meyer, Gerald J Dal Pan, Esther H Zhou

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PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical toxicology (Philadelphia, Pa.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sara KaramiCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0000-0001-7658-7977
Christian Angelo I VenturaCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0000-0002-4640-9421
Ellen PinnowCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0000-0002-9183-4662
Ibrahim IbrahimCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0009-0006-2493-0562
Dorothy ChangCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0009-0007-3734-2118
Ajoa AsonyeCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0009-0004-6609-5353
Lynda McCulleyCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0000-0003-0935-3876
Tamra MeyerCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0009-0008-9923-8444
Gerald J Dal PanCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0000-0003-4874-5864
Esther H ZhouCenter for Drug Evaluation and Research (CDER), U.S. Food and Drug Administration (FDA), Silver Spring, Maryland, USA.ORCID 0000-0003-4608-6850

Funding

Intramural FDA HHS FD999999
6 · The paper itself

Abstract

introductionThe objective of this study is to examine US Poison Center intentional pediatric nonprescription analgesics/antipyretic and cold/cough exposure trends involving abuse/misuse and suspected suicide amid the COVID-19 pandemic.

methodsUsing descriptive and interrupted time-series analyses, we assessed monthly pediatric (6-17 years) exposure case rates involving nonprescription analgesic/antipyretic drugs containing paracetamol (acetaminophen), ibuprofen, acetylsalicylic acid, and naproxen, and cold/cough drugs containing dextromethorphan, guaifenesin, pseudoephedrine, and phenylephrine, before (1/1/2015-2/29/2020) and during (4/1/2020-4/30/2023) the COVID-19 pandemic. Statins served as a control.

resultsNearly half of pediatric intentional cough/cold (40-56%) and analgesic/antipyretic (51-62%) cases involved a single substance, unlike the control (22%). Most cases entailed intentional-suspected suicide exposures (cold/cough 55-78%; analgesic/antipyretic 89-92%; control 96%) followed by intentional-abuse/misuse (cold/cough 17-40%; analgesic/antipyretic 6-8%; control 3%). Cases commonly involved adolescents, 13-17 years (cold/cough 88-93%; analgesic/antipyretic 90-92%; control 88%) and females (cold/cough 56-71%; analgesic/antipyretic 84-85%; control 82%). Paracetamol intentional-abuse/misuse and dextromethorphan suspected suicide case rates declined immediately following the pandemic's onset (March 2020), among adolescents. Case rates for guaifenesin, paracetamol, and ibuprofen intentional-suspected suicides exceeded pre-pandemic levels and exhibited statistically significant increased trend changes for adolescents (0.016, 0.246, and 0.116 cases per million population per month, respectively); and for guaifenesin for female (0.03 cases per million population). Male and female intentional-abuse/misuse case rates trends for some study drugs also increased; primarily for adolescents.

conclusionSome analgesic/antipyretic and cold/cough intentional-suspected suicide case rates notably increased during the pandemic for adolescents, particularly females. This surge aligns with periods of increased psychological stress, suicidal ideation/attempts, and certain nonprescription drug exposures potentially attributed to the COVID-19 pandemic.

Indexed as

AnalgesicsAntipyreticsCoughCOVID-19Nonprescription DrugsAdolescentAntitussive AgentsChildCommon ColdFemaleHumansMalePoison Control CentersSubstance-Related DisordersUnited StatesAnalgesicsAntipyreticsAntitussive AgentsNonprescription DrugsAnalgesic & antipyretic drugscold & cough drugsCOVID-19pediatric suspected suicidespoison centers

Identifiers

PMID41705545
PMCPMC13047584

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.