The Impact of the Novel Coronavirus on Brazilian PICUs

Abstract

Objectives: To study the impact of the coronavirus disease 2019 pandemic, considering the physical distancing and schools closing, on the characteristics of admission and epidemiology on Brazilian PICUs. Design: Observational, multicenter, time series analysis, of electronic medical records from 15 PICU in Brazil. Data consisted of all March, April, and May PICU admissions from 2017 to 2020. Setting: Fifteen private PICUs in Brazil. Patients: Pediatric patients admitted to the PICU from March to May since 2017. Interventions: None. Measurements and Main Results: The period from March 11, 2020, to March 17, 2020, was considered the “intervention point” studied, corresponding to the suspension of school activities and the beginning of physical distancing in Brazil. During the pandemic period studied, there were 28 cases of coronavirus disease 2019 (one death). The mean age was higher ( p = 0.000), the length of stay was shorter ( p = 0.000), but mortality rates were similar among the periods ( p = 0.36). The model estimated a reduction of 1,483 PICU admissions from March 2020 to May 2020. At the end of May, there was an estimated drop of –146.6 bronchiolitis admissions (95% CI, –242.8 to –50.3; p = 0.016); –71 asthma admissions (95% CI, –93.6 to –48.63; p = 0.000); and –59 community-acquired pneumonia admissions (95% CI, –74.7 to –43.3; p = 0.000) per period. The model showed no effect of the “intervention” (physical distancing) on hospitalization rates for epilepsy, diarrhea, sepsis, bacterial meningitis, or surgery when analyzed individually. When assessed together, the model estimated a reduction of 73.6 admissions (95% IC, –132 to –15.2; p = 0.43). Conclusions: The coronavirus disease 2019 pandemic strongly affected Brazilian PICUs, reducing admissions, length of stay, and the epidemiological profile. The measures to oppose the coronavirus disease 2019 pandemic may have prevented thousands of PICU hospitalizations across the country.

Neonatal and Pediatric Emergency Room Visits in a Tertiary Center during the COVID-19 Pandemic in Italy

“…This may be consistent with the marked reduction in white codes in 2020, suggesting the population visiting our PED was generally sicker during COVID-19, thus requiring hospital care more frequently. Furthermore, as outlined by other studies [25,26], a lower number of patients required intensive care treatment (27 in 2019 vs. 11 in 2020), even though the PICU admission rate remained unchanged. Of note, the reduction in PICU admissions was related to a striking disappearance of respiratory infections.…”

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

“…In response, health service provision underwent a significant reorganization to address COVID-19 pressures. The impact on services for people with non-communicable diseases, especially those with associated risk, has been considerable [8] , [9] , [10] .…”

“…Epilepsy surgery and vagus nerve stimulator (VNS) implantation/adjustments were postponed or canceled [16] , [31] , [32] . Many neurologists were re-deployed to 'front lines' or Intensive Care Units to manage people with COVID-19, while others moved to remote working as they were in a high-risk group [8] , [32] , [33] , [34] . People with epilepsy and their caregivers stopped attending clinics due to restrictions, and remote consultations were increasingly used [35] , [36] , [37] .…”

Did the National Lockdown in Saudi Arabia Reduce Lower Respiratory Illnesses in Children?

“…Our theory was based on a similar pattern of drops in oxygen requirements, mechanical ventilation, and the need for ICU care. The reduction of ICU care echoed another study conducted in Brazil, describing a significant decrease in pediatric ICU admissions for asthma and respiratory infections ( 15 ). Additionally, there was no increase in the length of hospital stay, which proves that the severity of hospitalized patients remained the same throughout the study period.…”