Changes in Pediatric Intensive Care Admissions in Wisconsin During the 2020 COVID-19 Pandemic

We perceived changes in the frequency of and reasons for admissions to Wisconsin pediatric intensive care units (PICU) during the advent of the COVID-19 pandemic, and we hypothesized that the rates of total, scheduled, and respiratory viral admissions were lower during the first calendar year of the pandemic than would have been predicted by historical admission data. Such findings would reflect important changes in PICU utilization paradigms during the pandemic. There are no descriptions of PICU admission changes in a single American state during the pandemic.

We compared all Wisconsin PICU admissions during the COVID-19 pandemic in 2020 (the study epoch) to admissions in seasonally matched, growth-adjusted "no-COVID-19" projections generated by time series analysis of all Wisconsin PICU admissions in the previous 5 years (the control epoch).

We identified 27,425 PICU admissions with 294,577 associated diagnoses in the study and control epochs. Total admissions were 60 ± 9 week-1 in the study epoch versus 103 ± 4 projected (RR 0.63; 95% CI, 0.59-0.68; P  < 0.001). Scheduled admissions were 17 ± 6 week-1 in the study epoch versus 28 ± 3 projected (RR 0.61; 95% CI, 0.55-0.67; P < 0.001). Respiratory viral admissions were 8 ± 5 week-1 in the study epoch versus 19 ± 9 projected (RR 0.40; 95% CI, 0.33-0.48; P < 0.001). Some admission categories experienced dramatic declines (c, respiratory/ear, nose, throat), while others experienced less decline (eg, injury/poisoning/adverse effects) or no significant change (eg, diabetic ketoacidosis). Except cases of COVID-19, no category had significantly increased weekly admissions. There were 104 admissions associated with COVID-19 diagnoses in 2020, 4.3% of the study epoch admissions.

We describe PICU admission changes in the first calendar year of COVID-19, informing health care staffing and service planning, as well as decisions regarding strategies to combat the evolving pandemic.