ABSTRACT
BackgroundBiliary Atresia (BA) is the commonest surgical cause of cholestasis in infancy, affecting 1 in 1700 live births in England and Wales. Previous reports have demonstrated an average of 50 BA cases every year across the three UK centres, however observations from clinicians across these three centers have suggested a reduction in the number of presenting cases during the COVID-19 lockdown.ObjectivesThe aim of this study was to assess whether there has been a change in presentations of Biliary Atresia (BA) in England and Wales during the first COVID-19 lockdown (January – July 2020).MethodsThis population study assessed all confirmed cases of BA, from January 2020 to July 2020, across the 3 UK paediatric liver centers originating from England and Wales. Data was then compared to the incidence of confirmed BA cases from January - July 2017, 2018 and 2019, as documented within the Biliary Atresia National Registry.ResultsFrom January – July 2020, there were only 8 presenting cases of BA in England and Wales, compared to 24, 17 and 20 for the same time periods in 2017, 2018 and 2019 respectively. This difference was significant in a two-sided t-test (p = 0.0150). While the mean days to Kasai procedure was longer in 2020 compared to 2016–2019 (64.6 vs. 56.6), this difference was not observed to be significant (p=0.551).ConclusionsThere was a significant reduction in the presenting cases of BA during the first COVID-19 lockdown. This could either be due to a reduction in referrals or from a reduction in incidence of the condition, potentially due to an infectious cause being less prevalent during the national lockdown. If the former is correct there is potential for a significant number of BA babies with cholestatic jaundice remaining within the community. General practitioners and community paediatricians should be alert for these patients.