Impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in a tertiary care centre

Abstract

Background: While COVID-19 per se does not seem to represent a significant threat to the paediatric population, the pandemic has caused indirect detrimental consequences in the management of children in paediatric intensive care units (PICUs). This study analyses the impact of the pandemic on PICU admission patterns in a tertiary care centre. Methods: We performed a retrospective observational study of all admissions to PICU during COVID-19 pandemic i.e. from April 2020-September 2021, and compared the data with corresponding pre-covid times. Results: There were 3439 inpatient admissions compared to 9478 admissions in corresponding pre-covid months. There were 486 admissions to PICU in 2020 compared to 1400 from corresponding pre-covid months (September 2018-March 2020). During the pandemic, there was a reduction in all PICU admissions (14%) compared to pre pandemic period. There was a 79% reduction in respiratory admissions, and a 90% reduction in children admitted with exacerbation of asthma. We also observed a reduction in trauma related admissions (60%) and also 63.5% reduction in seizure disorders. There were 64 admissions (13%) with COVID positive status with multisystem inflammatory syndrome in children (MIS-C) accounting for 9 cases. Conclusion: The spread of COVID-19 and subsequent policies to address the pandemic has had wide-reaching implications on children’s overall health seeking behaviour and wellbeing. A significant reduction in PICU admissions, particularly secondary to respiratory diseases, and lesser mortality in PICU was noted. This could be attributed to widely implicated public health measures like lockdown and shut down of schools. During times of pandemic and other public health emergencies, policy makers and service providers must ensure continued provision of essential healthcare and social services, including targeted responses for those with existing conditions to improve quality of life and reduce morbidity and mortality.

Keywords

• covid-19
• paediatric intensive care units
• admission patterns