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

Aim: During the coronavirus disease-2019 (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 PICU admissions during the COVID-19 outbreak. Materials and Methods: We included all patients admitted to a PICU from March 15th to September 15th 2020, and those admitted in the same period in 2019. Incidence rates ratios (IRR) between the 2019 and 2020 cohorts (IRR-1) and restriction periods (March 2020-June 2020) and post-restriction periods (July 2020-September 2020) (IRR-2) were computed using Poisson modelling according to the data distribution. We analyzed the number of PICU admissions and the patient characteristics. Results: A total of 437 patients from 465 admissions were included. In 2020, the number of PICU admissions significantly decreased by 65% compared to 2019 [0.355 (0.287-0.440)]. During the restriction period, the number of PICU admissions was significantly tower by 40.3% compared to the post-restriction period [0.597 (0.493-0.722)]. Lower respiratory tract infections (LRTIs) significantly decreased by 19% in the post-restriction period compared to the restriction period [0.811 (0.684-0.960)]. Cardiopulmonary arrests before PICU admission were significantly higher during the restriction period compared to the post-restriction period (15.5% vs 4.8%, p<0.015). Conclusion: It was shown that there was a significant decrease in all PICU admissions, especially those due to LRTIs during the COVID-19 period. During the restriction period, cardiopulmonary arrest prior PICU admission was higher compared to the post restriction period and 2019. Our study does not reveal an increase in illnesses severity scores but the significant increase in cardiopulmonary arrest may be explained by a delay in health care access and fear of COVID-19 transmission.