Complications of Serious Acute Conditions in Israeli Children during the COVID-19 Pandemic

Introduction: The coronavirus disease 2019 (COVID-19) initial outbreak resulted in a decrease in hospital admissions including conditions generally requiring the emergency department. Although most children with an acute COVID-19 infection are asymptomatic or mild (2), delayed access to medical services has been previously described . Since the outbreak of COVID-19 many reports have showed an increase in severe diabetic ketoacidosis (DKA) at diabetes diagnosis as well as higher rates of perforated appendicitis.

The question of delayed diagnosis and care and it’s causes continues to be a source of concern for childhood healthcare during a pandemic outbreak.

In this study, the overall rate of complications of serious pediatric conditions among children presenting to the pediatric emergency department (PED) during the first 3 months of the COVID-19 outbreak was evaluated.

Methods: This study was a multicenter cross-sectional retrospective study from 11 hospitals in Israel. Information regarding all admissions to the pediatric emergency departments during the SARS-CoV-2 outbreak and first lockdown period (1/3/2020- 31/5/2020) were compared to the parallel period in 2019.

Results: 43,860 and 26,205 patients presented to the participating PED’s during the study period in 2019 and 2020 respectively. The median age of the cohort was 4.6 years (interquartile range 1.25-11.3, 51.5% males).

Overall, 790 and 721 patients presented with serious pediatric conditions (6) with a complication rate of 10.2% and 11.7% during the study period in 2019 and 2020 respectively.

Conclusion: There was no observed increase of the rate of complications of serios medical conditions during the outbreak, compared with 2019.