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e386 | www.pidj.com © 2020 Wolters Kluwer Health, Inc. All rights reserved. Acute Meningoencephalitis as Initial Presentation of SARS-CoV-2 Infection in Pediatrics All 41 families who were approached participated. Responses showed that 37% (15/41) parents delayed seeking any medical attention as they avoided visiting their family doctor. Additionally, 10% (4/41) delayed attending hospital because of COVID-19 fears. Those 4 children had Escherchia coli knee septic arthritis and bacteremia (7-d delay), Staphylococcus aureus sacroiliac septic arthritis, myositis, and bacteremia (14 d), S. aureus calcaneal osteomyelitis with sequestrum and bacteremia (6 d), and culture-negative ventriculoperitoneal shunt infection (3 wks). About 10% (4/41) were advised against attending hospital by another healthcare professional. Infection-related admissions during COVID-19 restrictions halved compared with the previous year. Reduced admissions with respiratory infections were likely because of physical distancing (including school closures) and public health messaging including hand hygiene. Lower numbers of skin and osteoarticular infections may have been because of reduced trauma associated with fewer outdoor activities. Nonetheless, we found severe infections, which may have been less advanced if pandemic-related fears had not impacted on usual patterns and pathways of seeking healthcare. From available information to date, the risk in children of untreated serious infection far outweighs that of developing severe COVID-19. Globally, provision of primary care has been severely affected by staff shortages and redeployment to hospitals, but this has FIGURE 1. Infection-related inpatient admissions during COVID-19 restrictions in 2020 compared with 2019. LRTI, lower respiratory tract infection; SSTI, skin and soft tissue infection; URTI, upper respiratory tract infection; UTI, urinary tract infection.