Reasons for Admissions to US Children’s Hospitals During the COVID-19 Pandemic

A study led by PIRN Vice-Chair Dr. Peter Gill and PIRN Chair Dr. Sanjay Mahant published in JAMA on April 27, 2021 looked at hospitalization volumes in 42 US children’s hospitals before and during the COVID-19 pandemic by patient characteristics and by top 20 conditions in the Pediatric Clinical Classification System (PECCS).

The study noted major reductions in all-cause and many condition specific hospital admissions during Spring and Summer 2020. For example, median weekly bronchiolitis hospitalizations went from 476 admissions/week in Spring 2017-2019 to 26 admissions/week in 2020. Suicide and intentional injury was the only hospitalization category with a non-significant percentage increase in Summer 2020, from median 93 admissions/week (interquartile range [IQR] 87-102) to 109 admissions/week (IQR 93-128). Some potential reasons for the reduction in admissions including more watchful waiting of symptoms and increased thresholds for emergency department and hospital care, especially for lower-severity illnesses. Key limitations of the study include: no data for non-children’s hospitals and data from resurgence of COVID-19 in fall/winter 2020 were not available.