CHEST Guidelines-Changes-in-Pediatric-ICU-Utilization-and-Clinical-

Changes-in-Pediatric-ICU-Utilization-and-Clinical-

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The COVID-19 pandemic had a significant indirect impact on pediatric intensive care unit (PICU) admissions during the second quarter of 2020 in the United States. This study, examining data from 77 PICUs, found a 32% decrease in admissions compared to pre-pandemic levels (2017-2019). The most notable declines were observed in infection-related respiratory conditions, such as asthma and bronchiolitis, attributable to stay-at-home orders, mask mandates, and school closures. While general trauma admission percentages increased, the actual number of trauma cases decreased. Interestingly, admissions for diabetes mellitus and poisoning/ingestion rose, with diabetes seeing the largest increase.<br /><br />Mortality rates for PICU patients in this period were higher than previous years even after adjusting for illness severity, suggesting more severe presentations at admission possibly due to delays in care-seeking amidst the pandemic. This increase was linked to several factors, including reduced routine healthcare access, postponed elective surgeries, and strained healthcare systems.<br /><br />The study highlights the multifaceted impact of COVID-19 beyond direct infections, affecting health service utilization patterns and disease presentation in children. While elective admissions dropped, emergency cases altered in nature and severity, implying a shift in healthcare dynamics that may offer insights into the underlying causes of pediatric critical illnesses. Continuous assessment of these trends is vital to prepare for future public health crises and minimize indirect health effects on children.<br /><br />This research did not receive specific funding and emphasized the need for further studies to understand fully how COVID-19 and public health responses indirectly influenced pediatric health, particularly concerning chronic conditions like diabetes and acute incidents like poisoning. The study's limitations include its retrospective nature and reliance on database entries, although these were mitigated by strict quality controls.

Keywords

COVID-19 pandemic

pediatric intensive care

PICU admissions

respiratory conditions

asthma

diabetes mellitus

poisoning ingestion

healthcare access

public health impact

pediatric health