Pediatric Respiratory Illness Hospitalizations Prior to COVID-19 and During the First Year of the COVID-19 Pandemic in Southeast Wisconsin.

BACKGROUND: Public health measures combatting the COVID-19 pandemic also led to a decrease in other pediatric respiratory illnesses. We describe the local pattern of pediatric respiratory hospitalizations in southeast Wisconsin prior to COVID-19 and during the first year of the pandemic. METHODS: We performed a cross-sectional examination of hospitalizations for asthma, bronchiolitis, and bacterial pneumonia at a single tertiary children's hospital prior to COVID-19 through the first year of the COVID-19 pandemic. RESULTS: We found a significant decrease in the average monthly hospitalization rates prior to and during COVID-19 for asthma, bronchiolitis, and bacterial pneumonia (P < 0.001), with average percent decrease of hospitalizations per month of 48%, 78%, and 47.7%, respectively. CONCLUSIONS: The decrease in hospitalizations is likely multifactorial and related to public health measures, behavior changes, and other epidemiological factors.

Pediatric COVID-19 Delirium: Case Report of 2 Adolescents.

INTRODUCTION: Neurological complications of COVID-19, including delirium, are emerging in the adult population but have not been well described in pediatrics. CASE PRESENTATION: We report the cases of 2 adolescent males, ages 16 and 17, who presented with delirium secondary to an acute COVID-19 infection in the fall of 2020 at Children's Wisconsin in Milwaukee, Wisconsin. The foundation of our treatment strategy was the triad of alpha-2 agonists (clonidine, dexmedetomidine, guanfacine), antipsychotic agents (quetiapine, haloperidol, olanzapine), and melatonin. Discharge planning required involvement from inpatient psychiatry, case management, social work, and the family. Both patients showed improvement after several weeks. DISCUSSION: We believe these are the first reported cases of COVID-19-associated delirium in children outside of multisystem inflammatory syndrome in children (MIS-C). CONCLUSION: Pediatric COVID-19 delirium is a new manifestation of the COVID-19 disease. Treatment guidelines are emerging and lessons regarding therapies and discharge considerations are described in these 2 unique cases.