LAUSR

Background: Pediatric emergency departments (PED) reported a decrease in overall visits during the COVID-19 pandemic. Telemedicine, fewer visits for lower acuity complaints, and decreased transmission of infectious illnesses have contributed. These factors however may have less impact on ED usage by very young children. Study Objective: To characterize the early impact of COVID-19 mitigation efforts on the volume, presenting complaints and clinical course of newborns presenting to a tertiary care PED. Methods: We conducted a descriptive cross-sectional study of all visits by newborns, defined as children < 30 days of age, to a tertiary care PED in the U.S. during the onset of the SARS-CoV-2 pandemic. A state-wide shelter-at-home order was announced on 3/16/2020. Data abstracted from the electronic medical record during the 60-days following the order (3/16/2020-4/28/2020;study period) was compared to the same date range during 3 prior years (2017-2019;baseline period). Results: Of the 406 total newborn ED visits, 315 were in 2017-2019 (1.1% total ED volume for the baseline period) and 91 were in 2020 (2.3% total ED volume for the study period;P <.001). Mean age, insurance status and race distribution were unchanged;however, the study period proportion of Hispanic patients was significantly lower (27% vs 15.4%;P =.02). A higher proportion of study patients had imaging, procedures, and consults (23.2% vs 41.8%;P <.001, 11.4% vs 30.8%;P <.001, 10.8% vs 24.2%;P =.001). The most common chief complaints were similar with the top 3 complaints accounting for 40% of the baseline period and 48% of the study period. The study admission rate was 31.9% as compared to the baseline rate of 18.7%. Conclusions: Compared to the general population, visits to a tertiary care PED remained largely unchanged for newborn aged patients. While the most common chief complaint categories were consistent between time periods, a higher proportion of interventions and admissions occurred in the study population. [Formula presented] [Formula presented]