Impact of COVID-19 on Respiratory Admissions in a Tertiary Pediatric Intensive Care Unit

Background Pediatric inpatient admissions for viral respiratory infections decreased worldwide during the early part of the coronavirus disease 2019 (COVID-19) pandemic. This was likely due to social distancing measures and mask mandates leading to a decreased spread of viruses. We question if there was an increase in respiratory admissions during the winter of 2020-2021 due to the overlap of seasonal respiratory viruses and COVID-19 and the severity of those admissions. Methods We performed a single-center retrospective chart review of all respiratory admissions to our pediatric intensive care unit (PICU) from October to April during the years 2018-2019, 2019-2020, and 2020-2021. We compared the total number of respiratory admissions from different viruses and respiratory admissions by diagnoses among those time periods. Second, we compared the PICU length of stay and duration of mechanical ventilation (both invasive and non-invasive) for these respiratory admissions during those years. Results We saw a drastic decrease in the total respiratory admissions to the PICU in 2020-2021 compared to the same period of time in the last two years. The greatest contributor to this decrease was admissions secondary to bronchiolitis. We noticed a statistically significant decrease in both asthma (p<0.001) and chronic respiratory failure admissions (p=0.0029) during the pandemic winter compared to previous winters. Although, the total number of all respiratory viral admissions is not significant, admissions specific to the respiratory syncytial virus (RSV) (p<0.0001), rhino-enterovirus (p<0.0001), and multi-virus (p=0.0016), achieved statistical significance. There was no statistical difference between the PICU length of stay and duration of mechanical ventilation during the three years. Conclusion Despite a decrease in pediatric respiratory admissions during the COVID-19 pandemic, the severity of illness based on length of stay in the PICU and length of time on respiratory support remains unchanged compared to the previous two years.