Pediatric Hospitalizations During the COVID-19 Pandemic

Wilder, Jayme L.; Parsons, Chase R.; Growdon, Amanda S.; Toomey, Sara L.; Mansbach, Jonathan M.

doi:10.1542/peds.2020-005983

Cited by 82 publications

(75 citation statements)

References 9 publications

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“…Our observation of declines in inpatient care for many infections and infection-mediated diseases (eg, asthma) are consistent with other studies examining ED and inpatient resource use during COVID including asthma, croup, bronchiolitis, and pneumonia. [24][25][26] Notably, the specific conditions with the greatest declines in our study are all conditions that may be affected by changes in community viral and bacterial transmission. Thus, social distancing and policies including school closures may have had a cumulative impact on declines in admissions in addition to the factors described above.…”

Section: Discussionmentioning

confidence: 83%

“…11 Similarly, Wilder et al describe declines in overall hospitalizations per week at a single tertiary care pediatric hospital. 24 The substantial reductions that we observed likely reflect a complex interplay of factors, including among others, the influence of fear on health seeking behavior, adherence to social distancing policies, knowledge for when to seek healthcare, , and the impact of social distancing and school closures on transmission of respiratory infections.…”

Section: Discussionmentioning

confidence: 86%

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Inpatient Use and Outcomes at Children’s Hospitals During the Early COVID-19 Pandemic

et al. 2021

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This is a prepublication version of an article that has undergone peer review and been accepted for publication but is not the final version of record. This paper may be cited using the DOI and date of access. This paper may contain information that has errors in facts, figures, and statements, and will be corrected in the final published version. The journal is providing an early version of this article to expedite access to this information. The American Academy of Pediatrics, the editors, and authors are not responsible for inaccurate information and data described in this version.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 86%

Inpatient Use and Outcomes at Children’s Hospitals During the Early COVID-19 Pandemic

et al. 2021

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“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), the virus causing COVID-19, has caused a devastating pandemic with over 100 million cases and 2 million deaths globally so far ( 1 ). To date, children have been relatively spared from severe disease and death, representing around 2% of hospitalizations and <1 in every 1,000 COVID-19 deaths ( 2 ). However, pediatric patients with underlying conditions have higher rates of hospitalization and death compared with previously healthy children ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

Influenza vs. COVID-19: Comparison of Clinical Characteristics and Outcomes in Pediatric Patients in Mexico City

et al. 2021

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Introduction: Respiratory viruses are among the leading causes of disease and death among children. Co-circulation of influenza and SARS-CoV2 can lead to diagnostic and management difficulties given the similarities in the clinical picture.Methods: This is a cohort of all children hospitalized with SARS-CoV2 infection from March to September 3rd 2020, and all children admitted with influenza throughout five flu-seasons (2013–2018) at a pediatric referral hospital. Patients with influenza were identified from the clinical laboratory database. All hospitalized patients with confirmed SARS-CoV2 infection were followed-up prospectively.Results: A total of 295 patients with influenza and 133 with SARS-CoV2 infection were included. The median age was 3.7 years for influenza and 5.3 years for SARS-CoV2. Comorbidities were frequent in both groups, but they were more common in patients with influenza (96.6 vs. 82.7%, p < 0.001). Fever and cough were the most common clinical manifestations in both groups. Rhinorrhea was present in more than half of children with influenza but was infrequent in those with COVID-19 (53.6 vs. 5.8%, p < 0.001). Overall, 6.4% percent of patients with influenza and 7.5% percent of patients with SARS-CoV2 infection died. In-hospital mortality and the need for mechanical ventilation among symptomatic patients were similar between groups in the multivariate analysis.Conclusions: Influenza and COVID-19 have a similar picture in pediatric patients, which makes diagnostic testing necessary for adequate diagnosis and management. Even though most cases of COVID-19 in children are asymptomatic or mild, the risk of death among hospitalized patients with comorbidities may be substantial, especially among infants.

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“…Conversely, empirical data from high-income settings has demonstrated reductions in acute paediatric respiratory hospitalisations resulting from COVID-19 public health measures. [34][35][36] Investment in water and sanitation, a focus on hand-washing and efforts to strengthen oxygen systems in response to COVID-19 should all improve child survival.…”

Section: Discussionmentioning

confidence: 99%

Integrated Sustainable Childhood Pneumonia and Infectious Disease Reduction in Nigeria (INSPIRING) Through Whole System Strengthening in Jigawa, Nigeria: Study Protocol For a Cluster Randomised Controlled Trial

King¹,

Burgess²,

Bakare³

et al. 2021

Preprint

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BackgroundChild mortality remains unacceptably high, with Northern Nigeria reporting some of the highest rates globally (e.g. 192/1000 live births in Jigawa State). Coverage of key protect and prevent interventions, such as vaccination and clean cooking fuel use, are low. Additionally, knowledge, care-seeking and health system factors are poor. Therefore, a whole systems approach is needed for sustainable reductions in child mortality.MethodsThis is a cluster randomised controlled trial, with integrated process and economic evaluations, conducted from January 2021 – September 2022. The trial will be conducted in Kiyawa Local Government Area, Jigawa State, Nigeria, with an estimated population of 230,000. Clusters are defined as primary government health facility catchment areas (n=33). The 33 clusters will be randomly allocated (1:1) in a public ceremony, and 32 clusters included in the impact evaluation. The trial will evaluate a locally adapted ‘whole systems strengthening’ package of three evidence-based methods: community men’s and women’s groups; Partnership Defined Quality Scorecard; healthcare worker training, mentorship and provision of basic essential equipment and commodities. The primary outcome is mortality of children aged 7 days to 59 months. Mortality will be recorded prospectively using a cohort design, and secondary outcomes measured through baseline and endline cross-sectional surveys. Assuming the following, we will have a minimum detectable effect size of 30%: a) baseline mortality of 100 per 1000 livebirths; b) 4,480 compounds with 3 eligible children per compound; c) 80% power; d) 5% significance; e) intra-cluster correlation of 0.007; f) coefficient of variance of cluster size of 0.74. Analysis will be by intention-to-treat, comparing intervention and control clusters, adjusting for compound and trial clustering. DiscussionThis study will provide robust evidence of the effectiveness and cost-effectiveness of community-based participatory learning and action, with integrated health system strengthening and accountability mechanisms, to reduce child mortality. The ethnographic process evaluation will allow for a rich understanding of how the intervention works in this context. However, we encountered a key challenge in calculating the sample size, given the lack of timely and reliable mortality data, and the uncertain impacts of the COVID-19 pandemic. Trial registrationISRCTN 39213655, registered 11th December 2019

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Pediatric Hospitalizations During the COVID-19 Pandemic

Cited by 82 publications

References 9 publications

Inpatient Use and Outcomes at Children’s Hospitals During the Early COVID-19 Pandemic

Inpatient Use and Outcomes at Children’s Hospitals During the Early COVID-19 Pandemic

Influenza vs. COVID-19: Comparison of Clinical Characteristics and Outcomes in Pediatric Patients in Mexico City

Integrated Sustainable Childhood Pneumonia and Infectious Disease Reduction in Nigeria (INSPIRING) Through Whole System Strengthening in Jigawa, Nigeria: Study Protocol For a Cluster Randomised Controlled Trial

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