Multicenter Study of the Impact of COVID-19 Shelter-In-Place on Tertiary Hospital-based Care for Pediatric Neurologic Disease.
Publication/Presentation Date
4-1-2022
Abstract
OBJECTIVE: To describe changes in hospital-based care for children with neurologic diagnoses during the initial 6 weeks following regional Coronavirus 2019 Shelter-in-Place orders.
METHODS: This retrospective cross-sectional study of 7 US and Canadian pediatric tertiary care institutions included emergency and inpatient encounters with a neurologic primary discharge diagnosis code in the initial 6 weeks of Shelter-in-Place (COVID-SiP), compared to the same period during the prior 3 years (Pre-COVID). Patient demographics, encounter length, and neuroimaging and electroencephalography use were extracted from the medical record.
RESULTS: 27,900 encounters over 4 years were included. Compared to Pre-COVID, there was a 54% reduction in encounters during Shelter-in-Place. COVID-SiP patients were younger (median 5 years vs 7 years). The incidence of encounters for migraine fell by 72%, and encounters for acute diagnoses of status epilepticus, infantile spasms, and traumatic brain injury dropped by 53%, 55%, and 56%, respectively. There was an increase in hospital length of stay, relative utilization of intensive care, and diagnostic testing (long-term electroencephalography, brain MRI, and head CT (all
CONCLUSION: During the initial 6 weeks of SiP, there was a significant decrease in neurologic hospital-based encounters. Those admitted required a high level of care. Hospital-based neurologic services are needed to care for acutely ill patients. Precise factors causing these shifts are unknown and raise concern for changes in care seeking of patients with serious neurologic conditions. Impacts of potentially delayed diagnosis or treatment require further investigation.
Volume
12
Issue
2
First Page
218
Last Page
226
ISSN
1941-8744
Published In/Presented At
Hutchinson, M. L., Nash, K. B., Abend, N. S., Moharir, M., Wells, E., Messer, R. D., Palaganas, J., Helbig, I., Wietstock, S. O., Suslovic, W., Gonzalez, A. K., Kaufman, M. C., Press, C. A., Piantino, J., & Pediatric Neurohospitalist Work Group (2022). Multicenter Study of the Impact of COVID-19 Shelter-In-Place on Tertiary Hospital-based Care for Pediatric Neurologic Disease. The Neurohospitalist, 12(2), 218–226. https://doi.org/10.1177/19418744211063075
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
35414846
Department(s)
Department of Pediatrics
Document Type
Article