Sexually Transmitted Infection Diagnoses at Children's Hospitals During COVID-19

COVID-19 mitigation strategies resulted in changes in health care access and utilization, which could negatively impact adolescents at risk for sexually transmitted infections (STIs). We evaluated changes in STI diagnoses during adolescent visits at children's hospitals during COVID-19.

We conducted a retrospective cohort study using the Pediatric Health Information System database comparing adolescent (11-18 years) hospital visits with an STI diagnosis by International Classification of Diseases, 10th revision, code during COVID-19 (2020) to pre-COVID-19 (2017-2019). Data were divided into spring (March 15-May 31), summer (June 1-August 31), and fall (September 1-December 31). Median weekly visits and patient characteristics were compared using median regression.

Of 2 747 135 adolescent encounters, there were 10 941 encounters with an STI diagnosis from 44 children's hospitals in 2020. There was a decrease in overall median weekly visits for STIs in spring during COVID-19 (n = -18.6%, P = .001) and an increase in overall visits in summer (11%, P = .002) during COVID-19. There were significant increases in inpatient median weekly visits for STIs in summer (30%, P = .001) and fall (27%, P = .003) during COVID-19. We found increases in Neisseria gonorrhoeae (50%, P < .001) and other STI diagnoses (defined as other or unspecified STI by International Classification of Diseases, 10th revision, code; 38%, P = .040) in fall COVID-19 (2020), and a decrease in pelvic inflammatory disease (-28%, P = .032) in spring COVID-19 (2020).

We found increases in median weekly adolescent inpatient visits with an STI diagnosis in summer and fall COVID-19 (2020). These findings were likely partially driven by changes in behaviors or health care access. Further work is needed to improve STI care and thus potentially improve related health outcomes.