ASPO069 - Pediatric Upper Respiratory Tract Infections during the COVID-19 Pandemic: The Pediatric Otolaryngology Perspective
Sunday, May 1, 2022
8:55 AM – 9:55 AM CT
Location: Landmark C
Shady I. Soliman, M.S.1, Joshua A. Stramiello, M.D.2, Raquel Good, M.A.2, Nicole Hickman, B.S.1, Rohith S. Voora, B.S.1, Matthew T. Brigger, M.D., M.P.H.2
1Univ. of California San Diego, La Jolla, CA, 2Division of Pediatric Otolaryngology, Rady Children’s Hosp. San Diego, San Diego, CA.
Medical Student University of California - San Diego La Jolla, California
Introduction: Upper respiratory tract infections (URI) are the most common infection in children in the U.S. Many conditions treated by pediatric otolaryngology practices are directly related to sequelae of URIs. In 2020, the COVID-19 pandemic resulted in a decrease in social engagement and close contact. The purpose is to assess the change in total URI clinic visits, emergency department (ED) visits and hospitalizations in the U.S. during the COVID-19 pandemic. Secondary outcomes included relative frequency of URIs by region.
Methods: The Pediatric Heath Information System database was queried for International Classification of Disease 10 codes for acute URI from January 2016 to December 2020. Hospitals with data for all years were included in the analysis and the remaining were excluded. Demographic and clinical data included age, sex, household income, and encounter type. Cross-sectional study was utilized to assess patients <18 years old who presented for URI.
Results: 34 hospital systems were analyzed, representing all five regions of the U.S. 2020 demonstrated a significant reduction (57.8%, p<0.001) in URIs compared to 2016-2019. Consistent with state-sanctioned “stay-at-home” orders, the largest difference in URIs occurred from April to June 2020, demonstrating a 5.4 fold reduction compared to 2016-2019 average (p < 0.001). From April to December 2020, URI clinic visits, ED visits, and hospitalizations were 74.2%, 23.5% and 33.1% compared to April-December 2016-2019 averages respectively. In 2020, Southeastern states were most likely to have increased rates of URI after June (39.4% URI cases relative to 2016-2019) while states in the Western region were least likely (23.3% URI cases relative to 2016-2019).
Conclusion: There was significant reduction in the total number of pediatric URI clinic visits, ED visits and hospitalizations in 2020 which had a direct effect on the clinical volume of pediatric otolaryngologists. The greatest reduction in URIs occurred during state-sanctioned stay-at-home order dates. States with increased rates of URIs after June 2020 were associated with shorter state-sanctioned stay-at-home orders. As recovery from the pandemic progresses, it is critical for pediatric otolaryngologists to learn lessons and better understand how to manage practices during such events.