6233 Impact of COVID-19 restrictions on paediatric flu-related morbidity and mortality in a UK district general hospital

Objectives The COVID-19 pandemic has had a profound impact on global healthcare systems, with various containment measures, such as lockdowns and social distancing guidelines, implemented to curb the virus's spread. While these measures effectively reduced COVID-19 transmission, they might have unforeseen consequences on other aspects of healthcare, including vaccination rates and disease morbidity and mortality. This study investigates how COVID-19 restrictions influenced paediatric flu-related morbidity and mortality in a UK District General Hospital. Methods We conducted a retrospective analysis of paediatric flu-related morbidity and mortality in our hospital from November 2018 to February 2023. Data was collected on attendance numbers in the Accident and Emergency (A&E) department, Paediatric Assessment Unit (PAU), and hospital wards during each flu season. Mortality data was also recorded for each season. We assessed the impact of COVID-19 restrictions on flu-related morbidity and mortality by comparing data from flu seasons before and after the implementation of these restrictions. Results Between January 2018 and December 2022, no deaths associated with Flu A and B were recorded. However, from January 2023 to February 24, 2023, the hospital reported three flu-related deaths. In the 2018–2019 flu season, there were 189 patient visits, with five in A&E, 145 in the PAU, and 39 in hospital wards. In the 2019–2020 season, 131 visits were recorded, including 14 in A&E, 83 in the PAU, and 34 in hospital wards. During the 2020–2021 season, only three visits occurred, with none in A&E, one in the PAU, and two in hospital wards. In the 2021–2022 season, there were 10 visits, comprising two in A&E, one in the PAU, and seven in hospital wards. In the 2022- 2023 season, 249 visits were recorded, with 78 in A&E, 139 in the PAU, and 30 in hospital wards. Mortality data for the 2022–2023 season indicated three flu-related deaths. Our study reveals a substantial reduction in paediatric flu-related morbidity and mortality during the COVID-19 pandemic. The decline in flu cases in the 2020–2021 season is attributed to COVID-19 restrictions that limited social interactions and curbed the transmission of respiratory viruses. However, an upswing in flu cases during the 2022- 2023 season suggests a potential correlation with the relaxation of COVID-19 restrictions and increased social interaction. Although the study did not measure flu vaccine uptake, our findings emphasize the critical role of flu vaccination in averting paediatric flu-related morbidity and mortality, especially during a pandemic. Future investigations should delve into vaccination rates and their impact on paediatric flu-related outcomes during and after the COVID-19 pandemic. Conclusion In summary, this study underscores the significance of influenza vaccination in the paediatric population, despite not measuring vaccine uptake. The observed increase in flu-related cases and deaths during the COVID-19 pandemic suggests that post-pandemic restrictions may have altered population immunity. This underscores the importance of sustained vaccination campaigns to prevent future outbreaks.