Infectious Disease

During the COVID-19 pandemic, admissions to the pediatric intensive care unit decreased significantly

September 03, 2021

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In the US, recordings in the pediatric intensive care unit showed significant changes in the diseases seen in patients and a significant decrease during the COVID-19 pandemic, according to results published in Chest.

“Serious infections, traumatic injuries, perioperative conditions, and acute exacerbations of chronic diseases such as asthma and diabetes are among the most common reasons for admission to a pediatric intensive care unit; Therefore, the pediatric critical illness epidemiology was likely sensitive to the indirect effects of COVID-19, ”Janine E. Zee-Cheng, MD, Associate Clinical Assistant Professor of Pediatrics, Indiana University School of Medicine, Indianapolis, and colleagues wrote.

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Using the Virtual Pediatric Systems database, this retrospective observational cohort study enrolled 160,295 children enrolled in pediatric intensive care units in 77 U.S. locations in the first and second quarters of 2017 and 2019 prior to COVID-19 and in the first and second quarters of 2020 Pandemic.

Average pediatric intensive care admissions were similar in Q1 2017 and 2019 before the COVID-19 pandemic and Q1 2020 during the pandemic (23,197 vs. 22,895 admissions per quarter). During the pandemic (20,157 vs. 13,627 admissions per quarter) there was a 32% decrease in pediatric intensive care admissions from the second quarter of the pre-COVID-19 years through the second quarter of 2020.

In the second quarter of 2017 and 2019 and in the second quarter of 2020, asthma (1,327 vs. 241 patients) and bronchiolitis (1,299 vs. 121 patients) showed the largest decreases in pediatric intensive care stays (P <0.001). From the second quarter of 2017 and 2019 and the second quarter of 2020, researchers observed an increase in children who required intubation (4,191 vs. 4,739), diabetes admissions (1,033 vs 1,276), and intoxication / ingestion (856 vs 946) ); however, the total number of children who required intubation decreased (4,191 vs. 2,920).

Compared to Q2 2017 and 2019, the disease severity-adjusted odds for ICU mortality for pediatric ICU patients increased in Q2 2020 in the multivariable model (OR = 1.17; 95% CI, 1-1.36; P. =. 047).

“The disproportionate effects on certain medical conditions offer unique insights into the causal factors underlying critical illness in children and should be further explored,” the researchers wrote. “Pending external validation, the observed increase in mortality risk warrants consideration to avoid indirect harm to children from this pandemic, which mainly affects adults.”

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