6644 Covid 19 pandemic: comparing the demographics, diagnoses and length of stay in patients admitted to the PICU before and after the coronavirus pandemic

Objectives In February 2020, the World Health Organisation declared the a global pandemic as a result of a COVID-19 outbreak from the SARS-CoV-2 virus¹ and shortly after between March and June 2020, the United Kingdom enforced a lockdown imposing restrictions on movement of people.² Whilst the pandemic had minimal direct impact on critical illness in paediatrics, there was a significant reduction in prevalence of unplanned admissions, respiratory disease and fewer child deaths in the Paediatric Intensive Care Unit (PICU).³ We analysed data of patients admitted to the PICU during January 2015 to December 2019 and compared it to data from April 2022 and March 2023 to determine whether there was a difference in admission numbers, diagnoses, length of stay and a comparison of the level of support patients needed. Methods We performed a retrospective study of patients aged under 18 admitted to the PICU in Queens Medical Centre, Nottingham. Using the local medical document archives and discharge letters, we collected data for patients admitted between January 2015 to December 2019 and April 2022 and March 2023. The data collected included age, date of admission and discharge, length of stay, place of admission, DCD diagnosis, diagnosis, PIM score and the need for inotropes, endotracheal intubation, tracheostomy insertion, use of non-invasive ventilation and high flow oscillatory ventilation. Results We reviewed 718 patients from January 2015 to December 2019 and 604 patients from January 2015 to December 2019. Before the pandemic the median length of stay was 4 days. The most common age of patients admitted to the unit before and after the pandemic was <1 year. The reason for admission/diagnosis of patients before the pandemic were medical illness (i.e. sepsis, bronchiolitis) and after was elective post operative care. The mode length of stay after the pandemic was 1 day slightly less than pre pandemic length of stay. Conclusion We concluded that the largest cohort of patients admitted to the PICU were under 2 years old post pandemic which was similar to results pre pandemic. The reasons for needing paediatric intensive care however were different with more medical illness related diagnosis pre pandemic as opposed to elective post operative care post pandemic, which may impact on the allocation of resources (i.e. staffing numbers, level of support needed). References https://www.gov.uk/government/publications/wuhan-novel-coronavirus-background-information/wuhan-novel-coronavirus-epidemiology-virology-and-clinical-features https://commonslibrary.parliament.uk/research-briefings/cbp-9068/ Kanthimathinathan HK, Buckley H, Davis PJ, Feltbower RG, Lamming C, Norman L, Palmer L, Peters MJ, Plunkett A, Ramnarayan P, Scholefield BR, Draper ES. In the eye of the storm: impact of COVID-19 pandemic on admission patterns to paediatric intensive care units in the UK and Eire. Crit Care. 2021 Nov 17;25(1):399. doi: 10.1186/s13054-021-03779-z. PMID: 34789305; PMCID: PMC8597872.