Jennifer van Helmond, MD
Pediatric Critical Care Fellow
Alfred I DuPont Hospital for Children
Wilmington, Delaware
Disclosure information not submitted.
Brittany Fitts, RN, BSN, CCRN
Database Coordinator
Nemours/Alfred I. duPont Hospital for Children, United States
Disclosure information not submitted.
Jigar Chauhan, MBBS, MD
Staff Intensivist, Attending Physician
Alfred I DuPont Hospital for Children, United States
Disclosure information not submitted.
Title: Child abuse-related admissions to the PICU during the COVID-19 pandemic and preceding years
INTRODUCTION/HYPOTHESIS: As a result of the coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures, emergency department visits and reporting to child protective services have decreased. Reduced access to care for children and their parents, in addition to the added psychosocial stressors resulting from the pandemic, may be important risk factors for child abuse and neglect. We investigated if pediatric intensive care (PICU) admissions related to suspected child abuse were higher in 2020-2021 COVID-19 pandemic months compared with previous years.
Methods: We completed a retrospective cross-sectional study at a tertiary children’s hospital comparing all admissions related to suspected child abuse to our PICU between March 2020 and March 2021, to those during January 2017 to February 2020. We collected demographic and clinical characteristics as well as outcomes from the electronic medical record. Admissions related to suspected child abuse as well as overall admission counts were compared between the period with COVID-19 and the period without COVID-19 using Poisson regression. Characteristics of patients admitted during COVID-19 and non-COVID-19 periods were compared using Mann-Whitney Rank Sum tests and Fisher Exact tests.
Results: Twenty patients were admitted during COVID-19 months (mean 1.54 patients/month 95%-CI:0.99–2.38) whereas 24 patients were admitted during months without COVID-19 (mean 0.63 patients/month 95%-CI:0.42–0.94); this was a statistically significantly higher rate (+244%, P=0.003). Overall PICU admissions per month were lower (-19%, P< 0.001). Patients admitted during the COVID-19 pandemic were older (median 1.0 interquartile range 0.6–5.8 years vs. median 0.4 interquartile range 0.2–1.8 years, P=0.028), but otherwise had similar demographic and clinical characteristics (sex, race, PRISM scores and primary diagnosis – trauma vs neglect) and outcomes (mortality).
Conclusions: Admissions to the PICU related to suspected child abuse increased during COVID-19 pandemic months. The COVID-19 pandemic and its associated restrictions that limit access to services to prevent child abuse continues to affect United States children and their parents. It is important to develop alternative service models that can be delivered while community mitigation measures are in place.