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Impact of COVID-19 on pediatric pulmonology healthcare practice
Halime Nayir Buyuksahin1, Nagehan Emiralioglu1, Dilber Ademhan Tural1
1Department of Pediatric Pulmonology, Ihsan Dogramaci Children's Hospital, Hacettepe University, Ankara, Turkey.
Insights
The COVID-19 pandemic significantly reduced pediatric pulmonology outpatient visits and laboratory procedures, including pulmonary function tests (PFTs) and flexible fiberoptic bronchoscopies (FFBs). However, hospitalizations for chronic lung diseases remained stable.
Area of Science:
- Pediatric Pulmonology
- Infectious Disease Epidemiology
- Healthcare Management
Background:
- The COVID-19 pandemic, caused by droplet-spread Coronavirus 2019 (COVID-19), has profoundly impacted healthcare delivery.
- Pediatric pulmonology units have experienced significant changes in patient management and service utilization.
Purpose of the Study:
- To evaluate the impact of the COVID-19 pandemic on clinical follow-up and hospital visits in a pediatric pulmonology unit.
- To compare healthcare utilization before and during the pandemic.
Main Methods:
- An observational descriptive study was conducted from January 2019 to December 2020.
- Data on outpatient visits, laboratory procedures (including pulmonary function tests (PFTs), diffusion capacity, plethysmography, lung clearance index (LCI), high-speed video microscopy, gastric aspirate sampling, and flexible fiberoptic bronchoscopy (FFB)), and hospitalizations were analyzed.
- Comparisons were made between the pre-pandemic year (2019) and the pandemic year (2020).
Main Results:
- Outpatient visits decreased by 42.2% in 2020 compared to 2019.
- Laboratory procedures saw substantial reductions: PFTs (spirometry) by 87.2%, diffusion capacity by 67.6%, plethysmography by 69.2%, LCI by 87.1%, high-speed video microscopy by 64.3%, gastric aspirate sampling by 75.5%, and FFB by 59.1%.
- Hospitalizations for pulmonary exacerbations in cystic fibrosis, interstitial lung disease, and primary ciliary dyskinesia did not significantly decrease.
Conclusions:
- The COVID-19 pandemic led to a significant decline in routine pediatric pulmonology outpatient visits and diagnostic procedures.
- Despite reduced clinic activity, critical care needs for chronic lung diseases, as indicated by hospitalization rates, remained consistent.
- Healthcare systems need strategies to maintain essential pediatric pulmonology services during public health crises.
Introduction:
Coronavirus 2019 (COVID-19) is typically spread by droplets and has had a remarkable effect on pediatric pulmonology healthcare practice. Here, we aimed to evaluate the effect of the COVID-19 pandemic on the clinical follow-up and hospital visits of patients followed up at a pediatric pulmonology unit at a tertiary care center.
Methods:
This study was an observational descriptive study performed at a tertiary care center pediatric pulmonology unit between January 2019 and December 2020. We analyzed the outpatient visits, laboratory procedures which including pulmonary function tests (PFTs), diffusion capacity assessment, plethysmography, and lung clearance index (LCI), high-speed video microscopy, gastric aspirate sampling, and Flexible fiberoptic bronchoscopy (FFB) during clinical follow-up, and hospitalization numbers of patients with chronic lung diseases during the COVID-19 pandemic and compared them with the previous year before the pandemic started.
Results:
In 2020, compared with 2019, outpatient visits decreased by 42.2%; from 8324 patients to 4804 patients and other laboratory procedures decreased after the pandemic started; PFTs including spirometry by 87.2%; from 2990 to 380 tests, diffusion capacity assessment from 172 to 55 tests, plethysmography from 172 to 53 and LCI from 70 to 9 tests, also high-speed video microscopy analyses by 64.3% from 300 to 107 patients, and gastric aspirate sampling by 75.5% from 42 to 9 patients. FFB procedures also decreased by 59.1%, from 142 to 58 patients, and only 15 were after the first reported case of COVID-19 in our country, and they were all for urgent indications. None of these patients was positive pretesting for COVID-19 who underwent the FFB. There was no significant decrease in patients' hospitalization due to pulmonary exacerbation in cystic fibrosis, interstitial lung disease, and primary ciliary dyskinesia.
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