Even though acute anxiety has received substantial rhetorical attention during the COVID-19 pandemic, to our knowledge it has not been subject to scientific inquiry until now. Although this study cannot confirm that any search was linked to a specific acute anxiety event or panic attack, it provides evidence of the collateral psychological effects stemming from COVID-19, and motivates several data-driven recommendations.First, surveillance should continue as changes during the pandemic may spark new increases in acute anxiety that necessitate a response. Second, in light of the pandemic, resource providers should better address acute anxiety. For instance, Illinois launched "Call4Calm," a hotline to help people cope with acute COVID-19 anxiety, and such programs could be expanded nationally. Third, more must be done to link those needing help with help. A "panic attack" Google query does not return any links to helplines, even though Google has pioneered the "OneBox" approach to mental health queries, highlighting life-saving results at the top of a user's search results (including suicide and addiction hotlines) rather than hoping searchers find actionable information by chance alone. The Google OneBox should be expanded to promote resources for acute anxiety, like SAMHSA's Disaster Distress Helpline, to meet potential increased demand during COVID-19 now and in the future.Time-sensitive decision-making during a pandemic underscores the importance of fostering an agile empirical approach that can continually monitor health threats, 6 including the ability to study an outcome without a priori anticipatory data collection. Mining internet searches may improve strategies to discover and subsequently address the collateral mental health consequences of COVID-19.
Bilateral pulmonary agenesis is a rare malformation with 13 cases previously reported. To our knowledge, none of these cases have been associated with hydrops fetalis. We report a 36 weeks, hydropic female infant (46XX) with bilateral pulmonary agenesis, unilateral microophthalmia, and bilateral renal dysplasia. These eye and pulmonary findings have now been associated several times and may constitute a new syndrome. Ultrasound examination before delivery showed polyhydramnios and fetal hydrops. At autopsy the heart was structurally normal, aside from absent pulmonary connections. The ductus arteriosus was partially closed. This was felt to be etiologic in the hydrops. As the source of the amniotic fluid here could not be urine or pulmonary secretions, direct fluid transfer from fetal vasculature or skin was the likely origin.
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