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In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire.
Kanthimathinathan, Hari Krishnan; Buckley, Hannah; Davis, Peter J; Feltbower, Richard G; Lamming, Caroline; Norman, Lee; Palmer, Lyn; Peters, Mark J; Plunkett, Adrian; Ramnarayan, Padmanabhan; Scholefield, Barnaby R; Draper, Elizabeth S.
  • Kanthimathinathan HK; Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
  • Buckley H; Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
  • Davis PJ; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
  • Feltbower RG; Paediatric Intensive Care Unit, Bristol Royal Hospital for Children, Bristol, UK.
  • Lamming C; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
  • Norman L; Department of Health Sciences, George Davies Centre, College of Life Sciences, University of Leicester, Leicester, UK.
  • Palmer L; Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
  • Peters MJ; Department of Health Sciences, George Davies Centre, College of Life Sciences, University of Leicester, Leicester, UK.
  • Plunkett A; Paediatric Intensive Care, Great Ormond Street Hospital NHS Foundation Trust, NIHR Biomedical Research Centre, London, UK.
  • Ramnarayan P; University College London Great Ormond Street Institute of Child Health, London, UK.
  • Scholefield BR; Paediatric Intensive Care Unit, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
  • Draper ES; Children's Acute Transport Service, Great Ormond Street Hospital NHS Foundation Trust, NIHR Biomedical Centre, London, UK.
Crit Care ; 25(1): 399, 2021 11 17.
Article in English | MEDLINE | ID: covidwho-1523316
ABSTRACT

BACKGROUND:

The coronavirus disease-19 (COVID-19) pandemic had a relatively minimal direct impact on critical illness in children compared to adults. However, children and paediatric intensive care units (PICUs) were affected indirectly. We analysed the impact of the pandemic on PICU admission patterns and patient characteristics in the UK and Ireland.

METHODS:

We performed a retrospective cohort study of all admissions to PICUs in children < 18 years during Jan-Dec 2020, using data collected from 32 PICUs via a central database (PICANet). Admission patterns, case-mix, resource use, and outcomes were compared with the four preceding years (2016-2019) based on the date of admission.

RESULTS:

There were 16,941 admissions in 2020 compared to an annual average of 20,643 (range 20,340-20,868) from 2016 to 2019. During 2020, there was a reduction in all PICU admissions (18%), unplanned admissions (20%), planned admissions (15%), and bed days (25%). There was a 41% reduction in respiratory admissions, and a 60% reduction in children admitted with bronchiolitis but an 84% increase in admissions for diabetic ketoacidosis during 2020 compared to the previous years. There were 420 admissions (2.4%) with either PIMS-TS or COVID-19 during 2020. Age and sex adjusted prevalence of unplanned PICU admission reduced from 79.7 (2016-2019) to 63.1 per 100,000 in 2020. Median probability of death [1.2 (0.5-3.4) vs. 1.2 (0.5-3.4) %], length of stay [2.3 (1.0-5.5) vs. 2.4 (1.0-5.7) days] and mortality rates [3.4 vs. 3.6%, (risk-adjusted OR 1.00 [0.91-1.11, p = 0.93])] were similar between 2016-2019 and 2020. There were 106 fewer in-PICU deaths in 2020 (n = 605) compared with 2016-2019 (n = 711).

CONCLUSIONS:

The use of a high-quality international database allowed robust comparisons between admission data prior to and during the COVID-19 pandemic. A significant reduction in prevalence of unplanned admissions, respiratory diseases, and fewer child deaths in PICU observed may be related to the targeted COVID-19 public health interventions during the pandemic. However, analysis of wider and longer-term societal impact of the pandemic and public health interventions on physical and mental health of children is required.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Intensive Care Units, Pediatric / Pandemics / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Child / Humans Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03779-z

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Intensive Care Units, Pediatric / Pandemics / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Child / Humans Country/Region as subject: Europa Language: English Journal: Crit Care Year: 2021 Document Type: Article Affiliation country: S13054-021-03779-z