6739 Acute overdose presentations in children under the age of 16 years before, during and after the COVID-19 pandemic in a district general hospital

Objectives To assess the number, age groups affected, causes, and outcomes of overdose presentations before, during and after the COVID-19 pandemic in children under 16 years. To identify association of overdose with mental health problems before, during and after the COVID-19 pandemic in children under 16 years. Methods Children up to 16 years of age, who visited the emergency department for overdose were enrolled. Data was collected retrospectively from electronic records for 2019, 2020, and 2022, from March to August, for auditing and to compare the lockdown at the peak of the pandemic (2020), with previous and subsequent years. Documentation in history was used to identify cases with mental health problems. Categorical variables were assessed for frequency, and associations were checked using chi-square tests (p <0.05 = significant). Results The number increased from 26 cases in 2019 to 58, during the peak of the pandemic in 2020, and to 116 after the pandemic (2022). 70–80% of the cases were females, in all three years. During 2020, < 5-year-old children constituted the most cases, at 53% (n=30), while elder children became more affected after the pandemic, with around 89% (n=103) of cases above 10 years, in 2022. Cases of intentional overdose increased to 90% (n=104) in 2022, from 43% (n=25) in 2020 and 54% (n=14) in 2019. Paracetamol was the commonest agent for overdose throughout, with 50–60% cases. Around 60% of cases in 2020 and 2022, did not require any treatment, while about 60% required treatment in 2019. 65% of cases (n=18) in 2019, 30% of cases (n=18) in 2020, and 40% of cases (n=46) in 2022, required admission. In 2022, 45% of cases (n=52) were significantly associated with mental health problems compared to 30–35% in 2019–20 (p<0.05). 40% of cases in 2019, 20% of cases in 2020 and 30% of cases in 2022 had significant association with previous self-harm (p<0.05). Conclusion The number of overdose cases increased post-COVID, with the majority being over 10 years of age. Intentional overdose increased during the pandemic and persisted after, and paracetamol was the commonest agent used. Most of the patients did not require admission. We found significant associations of overdose with mental health problems and previous self-harm We recommend further studies to assess the trend and impact of COVID-19 on national overdose presentations. References WHO-UNICEF Children and poisoning: world report on child injury prevention. World Health Organization. 2008. Meade J, Pediatric Clinics of North America, 2021.