How the Pandemic Impacted Resource Utilization in Hospitalized Children With Bacterial Infections

Abstract

We compared the quantity of labs ordered in selected hospitalized children throughout the COVID-19 pandemic. Utilization of X-ray, magnetic resonance imaging (MRI), echocardiograms, and electrocardiograms (ECG), length of stay (LOS) and timing of antibiotics were secondary outcomes. Retrospective cohort study of patients >60 days to <22 years with cellulitis, pneumonia, and urinary tract infections discharged from hospital medicine March 2018 to February 2020 (pre-) March 2020 to February 2022 (peak) and March 2022 to April 2023 (post peak). Fisher-Freeman-Halton exact test was performed for categorical variables. Kruskal-Wallis test compared continuous variables. Patients admitted peak pandemic incurred more labs and ECGs and fewer MRIs and X-rays. There were no differences in echocardiograms, LOS, or timing of antibiotics. While lab utilization returned to pre-pandemic levels, increased ECG use continued. Increased lab and ECG utilization was observed in patients with certain bacterial infections during the peak of the pandemic, likely reflective of diagnostic uncertainty.