In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire
Abstract Background The coronavirus disease-19 (COVID-19) pandemic had a relatively minimal direct impact on critical illness in children compared to adults. However, children and paediatric intensive care units (PICUs) were affected indirectly. We analysed the impact of the pandemic on PICU admissi...
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oai:doaj.org-article:677861465c5f499f835ffb3cd6e653802021-11-21T12:02:51ZIn the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire10.1186/s13054-021-03779-z1364-8535https://doaj.org/article/677861465c5f499f835ffb3cd6e653802021-11-01T00:00:00Zhttps://doi.org/10.1186/s13054-021-03779-zhttps://doaj.org/toc/1364-8535Abstract Background The coronavirus disease-19 (COVID-19) pandemic had a relatively minimal direct impact on critical illness in children compared to adults. However, children and paediatric intensive care units (PICUs) were affected indirectly. We analysed the impact of the pandemic on PICU admission patterns and patient characteristics in the UK and Ireland. Methods We performed a retrospective cohort study of all admissions to PICUs in children < 18 years during Jan–Dec 2020, using data collected from 32 PICUs via a central database (PICANet). Admission patterns, case-mix, resource use, and outcomes were compared with the four preceding years (2016–2019) based on the date of admission. Results There were 16,941 admissions in 2020 compared to an annual average of 20,643 (range 20,340–20,868) from 2016 to 2019. During 2020, there was a reduction in all PICU admissions (18%), unplanned admissions (20%), planned admissions (15%), and bed days (25%). There was a 41% reduction in respiratory admissions, and a 60% reduction in children admitted with bronchiolitis but an 84% increase in admissions for diabetic ketoacidosis during 2020 compared to the previous years. There were 420 admissions (2.4%) with either PIMS-TS or COVID-19 during 2020. Age and sex adjusted prevalence of unplanned PICU admission reduced from 79.7 (2016–2019) to 63.1 per 100,000 in 2020. Median probability of death [1.2 (0.5–3.4) vs. 1.2 (0.5–3.4) %], length of stay [2.3 (1.0–5.5) vs. 2.4 (1.0–5.7) days] and mortality rates [3.4 vs. 3.6%, (risk-adjusted OR 1.00 [0.91–1.11, p = 0.93])] were similar between 2016–2019 and 2020. There were 106 fewer in-PICU deaths in 2020 (n = 605) compared with 2016–2019 (n = 711). Conclusions The use of a high-quality international database allowed robust comparisons between admission data prior to and during the COVID-19 pandemic. A significant reduction in prevalence of unplanned admissions, respiratory diseases, and fewer child deaths in PICU observed may be related to the targeted COVID-19 public health interventions during the pandemic. However, analysis of wider and longer-term societal impact of the pandemic and public health interventions on physical and mental health of children is required.Hari Krishnan KanthimathinathanHannah BuckleyPeter J. DavisRichard G. FeltbowerCaroline LammingLee NormanLyn PalmerMark J. PetersAdrian PlunkettPadmanabhan RamnarayanBarnaby R. ScholefieldElizabeth S. DraperBMCarticleCOVID19Paediatric intensive care unitAdmission patternsCase mixMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care, Vol 25, Iss 1, Pp 1-9 (2021) |
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EN |
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COVID19 Paediatric intensive care unit Admission patterns Case mix Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 |
| spellingShingle |
COVID19 Paediatric intensive care unit Admission patterns Case mix Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Hari Krishnan Kanthimathinathan Hannah Buckley Peter J. Davis Richard G. Feltbower Caroline Lamming Lee Norman Lyn Palmer Mark J. Peters Adrian Plunkett Padmanabhan Ramnarayan Barnaby R. Scholefield Elizabeth S. Draper In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire |
| description |
Abstract Background The coronavirus disease-19 (COVID-19) pandemic had a relatively minimal direct impact on critical illness in children compared to adults. However, children and paediatric intensive care units (PICUs) were affected indirectly. We analysed the impact of the pandemic on PICU admission patterns and patient characteristics in the UK and Ireland. Methods We performed a retrospective cohort study of all admissions to PICUs in children < 18 years during Jan–Dec 2020, using data collected from 32 PICUs via a central database (PICANet). Admission patterns, case-mix, resource use, and outcomes were compared with the four preceding years (2016–2019) based on the date of admission. Results There were 16,941 admissions in 2020 compared to an annual average of 20,643 (range 20,340–20,868) from 2016 to 2019. During 2020, there was a reduction in all PICU admissions (18%), unplanned admissions (20%), planned admissions (15%), and bed days (25%). There was a 41% reduction in respiratory admissions, and a 60% reduction in children admitted with bronchiolitis but an 84% increase in admissions for diabetic ketoacidosis during 2020 compared to the previous years. There were 420 admissions (2.4%) with either PIMS-TS or COVID-19 during 2020. Age and sex adjusted prevalence of unplanned PICU admission reduced from 79.7 (2016–2019) to 63.1 per 100,000 in 2020. Median probability of death [1.2 (0.5–3.4) vs. 1.2 (0.5–3.4) %], length of stay [2.3 (1.0–5.5) vs. 2.4 (1.0–5.7) days] and mortality rates [3.4 vs. 3.6%, (risk-adjusted OR 1.00 [0.91–1.11, p = 0.93])] were similar between 2016–2019 and 2020. There were 106 fewer in-PICU deaths in 2020 (n = 605) compared with 2016–2019 (n = 711). Conclusions The use of a high-quality international database allowed robust comparisons between admission data prior to and during the COVID-19 pandemic. A significant reduction in prevalence of unplanned admissions, respiratory diseases, and fewer child deaths in PICU observed may be related to the targeted COVID-19 public health interventions during the pandemic. However, analysis of wider and longer-term societal impact of the pandemic and public health interventions on physical and mental health of children is required. |
| format |
article |
| author |
Hari Krishnan Kanthimathinathan Hannah Buckley Peter J. Davis Richard G. Feltbower Caroline Lamming Lee Norman Lyn Palmer Mark J. Peters Adrian Plunkett Padmanabhan Ramnarayan Barnaby R. Scholefield Elizabeth S. Draper |
| author_facet |
Hari Krishnan Kanthimathinathan Hannah Buckley Peter J. Davis Richard G. Feltbower Caroline Lamming Lee Norman Lyn Palmer Mark J. Peters Adrian Plunkett Padmanabhan Ramnarayan Barnaby R. Scholefield Elizabeth S. Draper |
| author_sort |
Hari Krishnan Kanthimathinathan |
| title |
In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire |
| title_short |
In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire |
| title_full |
In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire |
| title_fullStr |
In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire |
| title_full_unstemmed |
In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire |
| title_sort |
in the eye of the storm: impact of covid-19 pandemic on admission patterns to paediatric intensive care units in the uk and eire |
| publisher |
BMC |
| publishDate |
2021 |
| url |
https://doaj.org/article/677861465c5f499f835ffb3cd6e65380 |
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