Impact of the COVID-19 Pandemic on the Pediatric Intensive Care Unit Admissions: A Single Centre Experience

INTRODUCTION: During the COVID-19 pandemic, pediatric emergency department visits and pediatric intensive care unit (PICU) admissions were significantly decreased. This study aimed to evaluate the impact of prevention strategies on the PICU admissions during COVID-19 outbreak.
METHODS: We included all patients admitted to PICU from March 15th to September 15th, 2020, and those admitted in the same period in 2019. Incidence rates ratios (IRR) between 2019 and 2020 cohorts (IRR-1) and restriction (March 2020-June 2020) and post-restriction (July 2020-September 2020) (IRR-2) were computed using Poisson modelling according to the data distribution. We analyzed the number of PICU admission and patient characteristics.
RESULTS: A total of 437 patients of 465 admissions were included. In 2020, the number of PICU admission significantly decreased by 65% compared to 2019 (0.355[0.287-0.440]). During restriction period, the number of PICU admission significantly decreased by 40.3% compared to post-restriction period (0.597[0.493-0.722]). Lower respiratory tract infections (LRTIs) significantly decreased by 19% in post-restriction period compared to restriction period (0.811[0.684-0.960]). Cardiopulmonary arrest before PICU admission significantly increased during restriction period compared to post-restriction period (15.5% vs 4.8%, p<0.015).
DISCUSSION AND CONCLUSION: It was shown that there was a significant decrease in all PICU admissions especially due to LRTIs during the COVID period. During restriction period cardiopulmonary arrest prior PICU admission increased compared to post restriction period and 2019. Our study doesn't demonstrate an increase in illnesses severity scores but the significant increase in cardiopulmonary arrest may be explain with delay in health care access and fear of COVİD-19 transmission.