Consequences of Social Distancing Measures during the Covid-19 Pandemic First Wave on the Epidemiology of Children Admitted to Pediatric Intensive Care Units: A Systematic Review

ABSTRACT

BACKGROUND AND AIM: To synthesize knowledge describing the impact of social distancing measures (SDM) during the first wave of the COVID-19 pandemic on acute illness in children by focusing on the admission to pediatric emergency departments (PED) and intensive care units (PICU). METHOD(S) We searched Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, EPOC Register, MEDLINE, Evidence-Based Medicine Reviews, EMBASE, WHO database on COVID-19, Cochrane Resources on COVID-19, Oxford COVID-19 Evidence Service, Google Scholar for literature on COVID-19 in December 2020. We did not apply study design filtering. The primary outcomes of interest were the global incidence of admission to PICU and PED, disease etiologies, and elective/emergency surgeries. RESULT(S) We identified 6,660 records and eighty-seven articles met our inclusion criteria. All the studies were with before and after study design compared with the historical data, with an overall high risk of bias. The median daily PED admissions decreased to 65% in 39 included studies and a 54% reduction in PICU admission in eight studies. There was a significant decline reported in acute respiratory illness and LRTI in five studies with a median decrease of 63%. We did not find a consistent trend in the incidence of poisoning, but there was an increasing trend in burns, DKA, and a downward trend in trauma and unplanned surgeries. CONCLUSION(S) SDMs in the first wave of the COVID-19 pandemic reduced the global incidence of pediatric acute illnesses. Continual effort and research into the subject should be essential for us to protect the well-being of children.