Background: Although significantly increased mental health concerns were noted globally during the first year of the COVID-19 pandemic, much less is known about the mental health trends during the COVID-19 recovery period. We aimed to compare current anxiety or depression rates to those before and during the first year of the pandemic and to evaluate demographic differences. Methods: We analyzed Household Pulse Survey data prospectively collected from a representative U.S. population sample. We compared the anxiety or depression rates from the first pandemic year (04/2020–05/2021) and recovery period (06/2023–03/2024) from the national cohort and demographic subgroups using two-sided paired t-tests and regression analyses and compared these to pre-pandemic (01/2019–12/2019) rates using one-sided t-tests. Results: The national estimates for anxiety or depression improved during the recent COVID-19 recovery period as compared to the first year (29.5 ± 5.5 vs. 37.6 ± 3.1; p < 0.0001) but did not return to the pre-pandemic benchmark (29.5% vs. 10.8%; p < 0.001). Higher rates were noted in younger individuals aged 18–29 years (p < 0.0001), in individuals with less than a high school diploma (p < 0.0001), or with disabilities (p < 0.0001). Non-Hispanic Asians reported the lowest rates (p < 0.0001), and no significant gender differences were noted. Conclusion: The U.S. population’s mental health concerns have improved since the first year of the pandemic but remain above pre-pandemic benchmarks. Certain demographic subgroups are at higher risk, indicating the need for targeted health care and economic policy interventions to address these disparities.

BACKGROUND: The relationship between the prenatal diagnosis of congenital heart defects (CHDs) and age at CHD surgery is poorly understood, despite the known relationships between age at surgery and long-term outcomes. The objective of this study was to determine the associations between prenatal diagnosis of CHD and age at surgery, and whether these associations differ for critical and noncritical CHDs. METHODS: This is a cohort analysis of patients aged 0 to 9 years who received their initial cardiac surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago between 2015 and 2021 with prenatal diagnosis as the exposure variable. All data were obtained from the locally maintained Society of Thoracic Surgeons Congenital Heart Surgery Database at Lurie Children’s Hospital. We used multivariable fixed effects regression models to estimate the strength of the association of prenatal diagnosis with age at surgery among patients with critical (surgery ≤60 days) and noncritical (surgery >60 days) CHDs. RESULTS: Of 1131 individuals who met inclusion criteria, 532 (47%) had a prenatal diagnosis, 428 (38%) had critical CHDs, 533 (47%) were female, and the median age at surgery was 119 days (interquartile range, 11–309 days). After controlling for demographics, comorbidities, and surgical complexity, the mean age at surgery was significantly younger in those with prenatally versus postnatally diagnosed critical CHD (7.1 days sooner, P <0.001) and noncritical CHDs (atrial septal defects [12.4 months sooner, P =0.037], ventricular septal defects [6.0 months sooner, P <0.003], and noncritical coarctation of the aorta [1.8 months sooner, P =0.010]). CONCLUSIONS: Younger age at CHD surgery, which is associated with postsurgical neurodevelopmental and physical outcomes, is significantly associated with prenatal CHD diagnosis. This relationship was identified for both critical and noncritical CHDs.

This study focused on the potential risks of radiofrequency-induced heating of cardiac implantable electronic devices (CIEDs) in children and adults with epicardial and endocardial leads of varying lengths during cardiothoracic MRI scans. Infants and young children are the primary recipients of epicardial CIEDs, though the devices have not been approved as MR conditional by the FDA due to limited data, leading to pediatric hospitals either refusing the MRI service to most pediatric CIED patients or adopting a scan-all strategy based on results from adult studies. The study argues that risk–benefit decisions should be made on an individual basis. We used 120 clinically relevant epicardial and endocardial device configurations in adult and pediatric anthropomorphic phantoms to determine the temperature rise during RF exposure at 1.5 T. The results showed that there was significantly higher RF heating of epicardial leads than endocardial leads in the pediatric phantom, but not in the adult phantom. Additionally, body size and lead length significantly affected RF heating, with RF heating up to 12 °C observed in models based on younger children with short epicardial leads. The study provides evidence-based knowledge on RF-induced heating of CIEDs and highlights the importance of making individual risk–benefit decisions when assessing the potential risks of MRI scans in pediatric CIED patients.

Background: Patients born with single ventricle anatomy palliated with the Fontan procedure are at risk of lymphatic complications (LC), including plastic bronchitis, protein losing enteropathy, and ascites. The mechanism of LC, associated risk factors, and impact on end organ dysfunction and mortality are not well understood. Methods: We performed a single‐center, retrospective, cross‐sectional cohort study of patients with Fontan circulation seen at our center between 2009 and 2022. Univariate comparisons were completed comparing those with and without LC. Results: A total of 314 Fontan patients were included with a mean age of 20.2±10.7 years. Of those patients, 83 (26.4%) had at least 1 LC, including ascites (21.4%), protein losing enteropathy (11.8%), and plastic bronchitis (2.9%). Patients with LC were older (23.5±12.6 versus 19.1±9.8 years, P =0.001) and had their Fontan operation at an older age (5.5 with LC versus 4.0 years without LC, P <0.001). The presence of LC was associated with renal dysfunction ( P =0.004), thromboembolism ( P =0.01), and arrhythmia ( P <0.001). LC were also associated with higher mean Fontan pressures on catheterization (14.7±3.8 with LC versus 12.8±3.7 mm Hg without LC, P =0.003). Fontan patients with LC had higher rates of transplantation (25.3% versus 2.2%, P <0.001) and death (18.1% with LC versus 4.3% without LC, P <0.001). Conclusions: Fontan‐related lymphatic complications develop in 1 out of 4 patients by 20 years of age, and they are associated with older age, renal dysfunction, thromboembolism, and arrhythmia. Patients with LC have higher rates of transplantation and death. Our findings indicate that elevated central venous pressure, rather than systolic cardiac or atrioventricular valve function, is associated with these complications.