Reduced visits to pediatric eye care among socioeconomically disadvantaged patients during the COVID-19 pandemic.

We hypothesized that children with low socioeconomic status (SES) had disproportionately fewer eye care visits during the early COVID-19 pandemic and that these children would be less likely to use synchronous provider-to-patient telemedicine eye care visits. This study investigated changes in patient demographics at a large, academic pediatric eye center before and after the pandemic. A retrospective review of all visits from March 18, 2019, to May 31, 2019 (pre-COVID period) and of the same date range in 2020 (COVID period) was performed. Patient addresses were used to calculate the Area Deprivation Index (ADI), a validated measure of a neighborhood's SES. Patients who identified as non-White, and those requiring an interpreter had relatively fewer visits during the COVID period compared to the pre-COVID period. In addition, relatively fewer telemedicine visits were performed with patients who lived in a neighborhood classified as at or above the 50th ADI percentile (more disadvantaged).

Association of nucleated red blood cell count with mortality among neonatal intensive care unit patients.

BACKGROUND: Nucleated red blood cells (nRBCs) are associated with adverse outcomes for pediatric and adult intensive care patients. METHODS: The association between nRBC count and mortality was examined in an observational cohort of patients admitted to the neonatal intensive care unit from December 2015-December 2018. RESULTS: Among the 1059 patients with at least one nRBC count obtained, 45 infants (4.2%) experienced in-hospital mortality prior to NICU discharge, the primary outcome measured in this study. Infants with any nRBC count >0 had a significantly higher risk of mortality (5.3% [45/849] vs. 0% [0/351], p < 0.001 by Fisher exact), and time to mortality decreased with higher nRBC counts (Spearman correlation -0.59, p < 0.001). The association between nRBC count and mortality remained significant even when restricting only to infants who were older than 7 days at time of nRBC count. CONCLUSION: Among neonatal intensive care unit patients, including those >7 days old, nRBCs are associated with significantly elevated mortality risk. A prospective study to better characterize clinical co-variants is necessary to better establish the use of nRBCs as a predictor of mortality.