Decreased incidence of urinary tract infections in febrile infants aged ≤60 days during COVID-19 pandemic

AimTo investigate the incidence rate of urinary tract infections (UTIs) among febrile infants aged <= 60 days before, during, and after the COVID-19 pandemic.MethodsWe conducted a retrospective study in 2 Swedish paediatric emergency departments between 2014 and 2022. We included full-term infants aged <= 60 days with fever without source. We calculated the annual incidence rate of UTI per 1000 births.ResultsWe included 1589 full-term infants with fever without source. In 2020, 89 infants were evaluated in the emergency department versus 203-259 in 2017-2019. In 2020, the incidence rate of UTI was 1.43 per 1000 births/year versus 2.18-2.37 in 2017-2019. The median age, sex, fever duration, and urine testing were similar between the years 2017 and 2020.ConclusionThe number of febrile infants who presented to the paediatric emergency department and the incidence rate of UTIs decreased in 2020. This decrease might imply a systematic misdiagnosis of UTIs in infants with febrile viral infections. A more selective urine testing approach for febrile, previously healthy, infants should be considered to mitigate UTI misdiagnosis and its potential harmful effects.