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Unexpected Pediatric Benefits of the COVID-19 Pandemic

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Despite the extensive impact of the COVID-19 pandemic, children, as compared to adults, have been affected less severely. Nonetheless, there have been concerns that lockdown measures might have prompted delays in care-seeking with a resultant worsening of serious pediatric conditions.

The first case of infection with SARS-CoV-2 in Scotland was identified on March 1, 2020, and a U.K.-wide lockdown began on March 23. The lockdown measures were eased on May 29, and schools were opened on Aug. 12. The “natural experiment” of the pandemic provided an opportunity to determine influences of COVID-19 on pediatric use of emergent healthcare and on severe pediatric disease.

Williams and colleagues used Scotland’s complete national data sets to compare pediatric care and illness from March 23 to Aug. 9, 2020, with that of previous years. Theirs was a retrospective, population-based analysis of all emergent pediatric care and specifically included data from both of Scotland’s pediatric intensive care units. The study was limited to children from birth to 14 years of age.

Unscheduled after-hours primary care visits were reduced by 64% during the five-month-long lockdown, as compared to the same parts of 2016 through 2019 ( P < 0.001). Emergency department visits dropped by half ( P < 0.001). Hospital admissions for medical conditions dropped by about half ( P < 0.001), but hospital admissions for surgical admissions did not change significantly.

As a clue to the seriousness of clinical situations when presenting to emergency departments, Williams looked at the proportion of emergency department visits that prompted hospital admission. During the first week of the lockdown, there was an increased rate of admission following emergency department visits, but the admission rate quickly dropped to baseline after that.

There also was a reduction in the number/rate of emergent admissions for pediatric intensive care that required mechanical ventilation, but...