Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study

Thomas Christie Williams; Clare MacRae; Olivia Swann; Haris Haseeb; Steve Cunningham; Davies Philip; Christopher Lamb; Richard Levin; Catherine McDougall; Jillian  McFadzean; Ian Piper; Alistair Turner; Steve Turner; Margrethe Van Dijke; Don Urqhuart; Bruce Guthrie; Ross Langley

doi:10.1136/archdischild-2020-321008

Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study

Thomas Christie Williams, Clare MacRae, Olivia Swann, Haris Haseeb, Steve Cunningham, Davies Philip, Christopher Lamb, Richard Levin, Catherine McDougall, Jillian McFadzean, Ian Piper, Alistair Turner, Steve Turner, Margrethe Van Dijke, Don Urqhuart, Bruce Guthrie, Ross Langley^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Abstract

Objectives To determine the indirect consequences of the COVID-19 pandemic on paediatric healthcare utilisation and severe disease at a national level following lockdown on March 23, 2020.

Design National retrospective cohort study.

Setting Emergency childhood primary and secondary care providers across Scotland; two national Paediatric Intensive Care Units (PICUs); statutory death records.

Participants 273,455 unscheduled primary care attendances; 462,437 emergency department attendances; 54,076 emergency hospital admissions; 413 PICU unplanned emergency admissions requiring invasive mechanical ventilation; and 415 deaths during the lockdown study period and equivalent dates in previous years.

Main outcome measures Rates of emergency care consultations, attendances and admissions; clinical severity scores on presentation to PICU; rates and causes of childhood death. For all datasets, rates during the lockdown period were compared to mean or aggregated rates for the equivalent dates in 2016-19.

Results The rates of emergency presentations to primary and secondary care fell during lockdown in comparison to previous years. Emergency PICU admissions for children requiring invasive mechanical ventilation also fell as a proportion of cases for the entire population, with an odds ratio of 0.52 for likelihood of admission during lockdown (95% CI 0.37-0.73), compared to the equivalent period in previous years. Clinical severity scores did not suggest children were presenting with more advanced disease. The greatest reduction in PICU admissions was for diseases of the respiratory system; those for injury, poisoning or other external causes were equivalent to previous years. Mortality during lockdown did not change significantly compared to 2016-19.

Conclusions National lockdown led to a reduction in paediatric emergency care utilisation, without associated evidence of severe harm.

Original language	English
Pages (from-to)	911-917
Number of pages	7
Journal	Archives of Disease in Childhood
Volume	106
Issue number	9
Early online date	4 Jan 2021
DOIs	https://doi.org/10.1136/archdischild-2020-321008
Publication status	Published - 19 Aug 2021

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10.1136/archdischild-2020-321008

Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe diseaseAccepted author manuscript, 554 KBLicence: Creative Commons: Attribution Non-Commercial (CC-BY-NC)

ECAT Fellowship: Thomas Williams: Genome embedded ribonucleotides: causes and consequences
Taylor, M. & Jackson, A.
UK-based charities
1/08/16 → 5/02/21
Project: Research

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Williams, T. C., MacRae, C., Swann, O., Haseeb, H., Cunningham, S., Philip, D., Lamb, C., Levin, R., McDougall, C., McFadzean, J., Piper, I., Turner, A., Turner, S., Van Dijke, M., Urqhuart, D., Guthrie, B., & Langley, R. (2021). Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study. Archives of Disease in Childhood, 106(9), 911-917. https://doi.org/10.1136/archdischild-2020-321008

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title = "Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study",

abstract = "AbstractObjectives To determine the indirect consequences of the COVID-19 pandemic on paediatric healthcare utilisation and severe disease at a national level following lockdown on March 23, 2020. Design National retrospective cohort study.Setting Emergency childhood primary and secondary care providers across Scotland; two national Paediatric Intensive Care Units (PICUs); statutory death records. Participants 273,455 unscheduled primary care attendances; 462,437 emergency department attendances; 54,076 emergency hospital admissions; 413 PICU unplanned emergency admissions requiring invasive mechanical ventilation; and 415 deaths during the lockdown study period and equivalent dates in previous years.Main outcome measures Rates of emergency care consultations, attendances and admissions; clinical severity scores on presentation to PICU; rates and causes of childhood death. For all datasets, rates during the lockdown period were compared to mean or aggregated rates for the equivalent dates in 2016-19.Results The rates of emergency presentations to primary and secondary care fell during lockdown in comparison to previous years. Emergency PICU admissions for children requiring invasive mechanical ventilation also fell as a proportion of cases for the entire population, with an odds ratio of 0.52 for likelihood of admission during lockdown (95% CI 0.37-0.73), compared to the equivalent period in previous years. Clinical severity scores did not suggest children were presenting with more advanced disease. The greatest reduction in PICU admissions was for diseases of the respiratory system; those for injury, poisoning or other external causes were equivalent to previous years. Mortality during lockdown did not change significantly compared to 2016-19. Conclusions National lockdown led to a reduction in paediatric emergency care utilisation, without associated evidence of severe harm.",

author = "Williams, {Thomas Christie} and Clare MacRae and Olivia Swann and Haris Haseeb and Steve Cunningham and Davies Philip and Christopher Lamb and Richard Levin and Catherine McDougall and Jillian McFadzean and Ian Piper and Alistair Turner and Steve Turner and {Van Dijke}, Margrethe and Don Urqhuart and Bruce Guthrie and Ross Langley",

year = "2021",

month = aug,

day = "19",

doi = "10.1136/archdischild-2020-321008",

language = "English",

volume = "106",

pages = "911--917",

journal = "Archives of Disease in Childhood",

issn = "0003-9888",

publisher = "BMJ Publishing Group Ltd",

number = "9",

}

Williams, TC , MacRae, C , Swann, O, Haseeb, H, Cunningham, S, Philip, D, Lamb, C, Levin, R, McDougall, C, McFadzean, J, Piper, I, Turner, A, Turner, S, Van Dijke, M, Urqhuart, D, Guthrie, B & Langley, R 2021, 'Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study', Archives of Disease in Childhood, vol. 106, no. 9, pp. 911-917. https://doi.org/10.1136/archdischild-2020-321008

TY - JOUR

T1 - Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study

AU - Williams, Thomas Christie

AU - MacRae, Clare

AU - Swann, Olivia

AU - Haseeb, Haris

AU - Cunningham, Steve

AU - Philip, Davies

AU - Lamb, Christopher

AU - Levin, Richard

AU - McDougall, Catherine

AU - McFadzean, Jillian

AU - Piper, Ian

AU - Turner, Alistair

AU - Turner, Steve

AU - Van Dijke, Margrethe

AU - Urqhuart, Don

AU - Guthrie, Bruce

AU - Langley, Ross

PY - 2021/8/19

Y1 - 2021/8/19

N2 - AbstractObjectives To determine the indirect consequences of the COVID-19 pandemic on paediatric healthcare utilisation and severe disease at a national level following lockdown on March 23, 2020. Design National retrospective cohort study.Setting Emergency childhood primary and secondary care providers across Scotland; two national Paediatric Intensive Care Units (PICUs); statutory death records. Participants 273,455 unscheduled primary care attendances; 462,437 emergency department attendances; 54,076 emergency hospital admissions; 413 PICU unplanned emergency admissions requiring invasive mechanical ventilation; and 415 deaths during the lockdown study period and equivalent dates in previous years.Main outcome measures Rates of emergency care consultations, attendances and admissions; clinical severity scores on presentation to PICU; rates and causes of childhood death. For all datasets, rates during the lockdown period were compared to mean or aggregated rates for the equivalent dates in 2016-19.Results The rates of emergency presentations to primary and secondary care fell during lockdown in comparison to previous years. Emergency PICU admissions for children requiring invasive mechanical ventilation also fell as a proportion of cases for the entire population, with an odds ratio of 0.52 for likelihood of admission during lockdown (95% CI 0.37-0.73), compared to the equivalent period in previous years. Clinical severity scores did not suggest children were presenting with more advanced disease. The greatest reduction in PICU admissions was for diseases of the respiratory system; those for injury, poisoning or other external causes were equivalent to previous years. Mortality during lockdown did not change significantly compared to 2016-19. Conclusions National lockdown led to a reduction in paediatric emergency care utilisation, without associated evidence of severe harm.

AB - AbstractObjectives To determine the indirect consequences of the COVID-19 pandemic on paediatric healthcare utilisation and severe disease at a national level following lockdown on March 23, 2020. Design National retrospective cohort study.Setting Emergency childhood primary and secondary care providers across Scotland; two national Paediatric Intensive Care Units (PICUs); statutory death records. Participants 273,455 unscheduled primary care attendances; 462,437 emergency department attendances; 54,076 emergency hospital admissions; 413 PICU unplanned emergency admissions requiring invasive mechanical ventilation; and 415 deaths during the lockdown study period and equivalent dates in previous years.Main outcome measures Rates of emergency care consultations, attendances and admissions; clinical severity scores on presentation to PICU; rates and causes of childhood death. For all datasets, rates during the lockdown period were compared to mean or aggregated rates for the equivalent dates in 2016-19.Results The rates of emergency presentations to primary and secondary care fell during lockdown in comparison to previous years. Emergency PICU admissions for children requiring invasive mechanical ventilation also fell as a proportion of cases for the entire population, with an odds ratio of 0.52 for likelihood of admission during lockdown (95% CI 0.37-0.73), compared to the equivalent period in previous years. Clinical severity scores did not suggest children were presenting with more advanced disease. The greatest reduction in PICU admissions was for diseases of the respiratory system; those for injury, poisoning or other external causes were equivalent to previous years. Mortality during lockdown did not change significantly compared to 2016-19. Conclusions National lockdown led to a reduction in paediatric emergency care utilisation, without associated evidence of severe harm.

U2 - 10.1136/archdischild-2020-321008

DO - 10.1136/archdischild-2020-321008

M3 - Article

SN - 0003-9888

VL - 106

SP - 911

EP - 917

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

IS - 9

ER -

Indirect effects of the COVID-19 pandemic on paediatric healthcare use and severe disease: a retrospective national cohort study

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ECAT Fellowship: Thomas Williams: Genome embedded ribonucleotides: causes and consequences

Cite this