Impact of COVID-19 on the severity and length of stay among hospitalized pediatric patients.

OBJECTIVE: Pediatric hospital admissions and emergency department visits decreased during the COVID-19 pandemic. The primary objective of this study was to determine if pediatric patients hospitalized during the pandemic were more severely ill compared with those during the pre-pandemic period by measuring severity of illness, intensive care unit admissions, and length of stay. METHODS: A cross-sectional study was conducted of patients admitted to an urban, large children's hospital in the Mid-Southern US from 2016 to 2021. A total of 58,369 admissions were included, with 42,877 pre-pandemic and 15,492 pandemic admissions. RESULTS: During the pandemic, admissions of more severe illnesses increased significantly compared with pre-pandemic admissions. Intensive care unit admission rates increased during the pandemic (11%) compared with pre-pandemic levels (9.9%). Length of stay did not differ. CONCLUSION: The severity of illness for hospitalized pediatric patients increased significantly during the COVID-19 pandemic. The increase may stem from unmet medical needs; patients must still receive routine, acute, and chronic care.