Non-COVID-19 reasons for hospitalisation among children during the COVID-19 pandemic compared with the pre-pandemic period – A prospective population-based study from Barbados

Abstract

Numerous studies from around the world have documented disruption as well as a decrease in child health services. In this study, we look at the impact of the pandemic from a different perspective. We compare the spectrum of non-COVID-19 illnesses which necessitated hospitalisation among children during this pandemic and the pre-pandemic times. This is a population-based prospective clinical audit of children (Age <16 years) admitted for COVID-19-unrelated illnesses during the ongoing COVID-19 pandemic. Data on admissions are routinely collected for clinical audits. The study period was extended from April 2020 to March 2022. The primary measured outcome was the primary discharge diagnosis. Other outcome measures were frequency of admissions, frequency of intensive care and number of deaths. The measured outcome during the pandemic was compared with the corresponding period in the pre-pandemic period. There were 1282 non-COVID medical admissions from children (<16 years) during the COVID-19 pandemic compared to the 2168 admissions during the corresponding months in the immediate pre-pandemic period. This corresponds to a decline of 40.7% (95% confidence interval = 8.1%, 42.9%). Mean monthly admissions from acute respiratory illnesses (acute exacerbation of asthma phenotypes and respiratory tract infections) and acute gastroenteritis was 5.4 (±1.8) and 2.6 (±0.7) during the pandemic months compared to 35.1 (±7.2) and 5.3 (±0.8) during the corresponding pre-pandemic months, respectively. Both these differences were statically significant (P < 0.0001). There was a significant decline in the admissions from medical illnesses among children and this was almost entirely due to a sharp and significant decline in admissions form acute respiratory illnesses and acute gastroenteritis.