Jeng-Hung Wu1, Ching-Chia Wang1, Frank Leigh Lu1, Shu-Chien Huang2, Yueh-Ping Liu3, Chun-Yi Lu1, Luan-Yin Chang1, En-Ting Wu4. 1. Department of Pediatrics, National Taiwan University Children's Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. 2. Department of Surgery, National Taiwan University Children's Hospital and National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. 3. Department of Medical Affairs, Ministry of Health and Welfare, Taipei, Taiwan. 4. Department of Pediatrics, National Taiwan University Children's Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: 008745@ntuh.gov.tw.
Abstract
BACKGROUND/ PURPOSE: Coronavirus disease 2019 (COVID-19) pandemic challenges pediatric health globally by limited medical accessibility. In response to COVID-19 epidemic in Taiwan, public restrictions were applied and the Level 3 alert was announced from May to July in 2021 for local outbreak. This study aims to analyze patients' clinical features and outcomes in the pediatric intensive care unit (PICU) during the COVID-19 epidemic with the Level 3 alert in Taiwan. METHODS: Medical records were retrospectively collected in patients admitted to the PICU of National Taiwan University Children's Hospital from May to July 2021 (Level 3 alert) and May to July 2019 and 2020 (control periods). Clinical characteristics and outcomes were compared between patients in the period with the Level 3 alert and control periods. RESULTS: During the study period, PICU monthly admissions significantly decreased in the Level 3 alert period and were negatively correlated with monthly newly confirmed COVID-19 cases. Patients admitted during the Level 3 alert were older, had higher disease severity, lower proportion of cardiovascular disease, and higher proportion of hematology-oncology diseases than those in the control group. After adjusting for the above factors, admission during Level 3 alert was an independent factor for higher mortality rate and prolonged length of stay (>14 days) in the PICU. CONCLUSION: During the COVID-19 epidemic with strict public restrictions, critically ill patients admitted to the PICU decreased but had increased disease severity, prolonged length of stay in the PICU, and higher mortality, reflecting the impact of quarantine and limited medical access.
BACKGROUND/ PURPOSE: Coronavirus disease 2019 (COVID-19) pandemic challenges pediatric health globally by limited medical accessibility. In response to COVID-19 epidemic in Taiwan, public restrictions were applied and the Level 3 alert was announced from May to July in 2021 for local outbreak. This study aims to analyze patients' clinical features and outcomes in the pediatric intensive care unit (PICU) during the COVID-19 epidemic with the Level 3 alert in Taiwan. METHODS: Medical records were retrospectively collected in patients admitted to the PICU of National Taiwan University Children's Hospital from May to July 2021 (Level 3 alert) and May to July 2019 and 2020 (control periods). Clinical characteristics and outcomes were compared between patients in the period with the Level 3 alert and control periods. RESULTS: During the study period, PICU monthly admissions significantly decreased in the Level 3 alert period and were negatively correlated with monthly newly confirmed COVID-19 cases. Patients admitted during the Level 3 alert were older, had higher disease severity, lower proportion of cardiovascular disease, and higher proportion of hematology-oncology diseases than those in the control group. After adjusting for the above factors, admission during Level 3 alert was an independent factor for higher mortality rate and prolonged length of stay (>14 days) in the PICU. CONCLUSION: During the COVID-19 epidemic with strict public restrictions, critically ill patients admitted to the PICU decreased but had increased disease severity, prolonged length of stay in the PICU, and higher mortality, reflecting the impact of quarantine and limited medical access.
Authors: Stéphane Leteurtre; Alain Martinot; Alain Duhamel; François Proulx; Bruno Grandbastien; Jacques Cotting; Ronald Gottesman; Ari Joffe; Jurg Pfenninger; Philippe Hubert; Jacques Lacroix; Francis Leclerc Journal: Lancet Date: 2003-07-19 Impact factor: 79.321
Authors: Hari Krishnan Kanthimathinathan; Hannah Buckley; Caroline Lamming; Peter Davis; Padmanabhan Ramnarayan; Richard Feltbower; Elizabeth S Draper Journal: Crit Care Explor Date: 2021-03-15
Authors: Eleftherios M Protopapas; Mauro Lo Rito; Vladimiro L Vida; George E Sarris; Christo I Tchervenkov; Bohdan J Maruszewski; Zdzislaw Tobota; Bistra Zheleva; Hao Zhang; Jeffery P Jacobs; Joseph A Dearani; Elizabeth H Stephens; James S Tweddell; Nestor F Sandoval; Emile A Bacha; Erle H Austin; Kisaburo Sakamoto; Sachin Talwar; Hiromi Kurosawa; Zohair Y Al Halees; Marcello B Jatene; Krishna S Iyer; Cheul Lee; Rajesh Sharma; Yasutaka Hirata; Frank Edwin; Jorge L Cervantes; James O'Brien; James St Louis; James K Kirklin Journal: World J Pediatr Congenit Heart Surg Date: 2020-08-26