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Related Concept Videos

Healthcare Associated Infections II: Preventive Measures01:22

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Related Experiment Video

Updated: May 26, 2025

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

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  • 1Section of Pediatric Hospital Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.

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Summary

During the COVID-19 pandemic, hospitalized children had more laboratory tests and electrocardiograms (ECGs) ordered. While lab use returned to normal, increased ECG utilization persisted post-peak.

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COVID-19MIS-C mimicshigh value carehospitalized childrenlab utilizationpediatric bacterial infectionsresource utilization

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Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Health Services Research

Background:

  • The COVID-19 pandemic significantly impacted healthcare delivery and resource utilization.
  • Understanding changes in diagnostic testing and clinical management during the pandemic is crucial for pediatric hospital medicine.

Purpose of the Study:

  • To compare laboratory test orders and imaging utilization in hospitalized children before, during, and after the peak of the COVID-19 pandemic.
  • To assess changes in electrocardiograms (ECGs), echocardiograms, X-rays, magnetic resonance imaging (MRIs), length of stay (LOS), and antibiotic timing.

Main Methods:

  • Retrospective cohort study of pediatric patients ( >60 days to <22 years) with cellulitis, pneumonia, or urinary tract infections.
  • Data collected from March 2018 to April 2023, divided into pre-pandemic, peak pandemic, and post-peak phases.
  • Statistical analysis included Fisher-Freeman-Halton exact test for categorical variables and Kruskal-Wallis test for continuous variables.

Main Results:

  • Patients admitted during the peak pandemic period had significantly more laboratory tests and ECGs ordered.
  • Fewer MRIs and X-rays were utilized during the peak pandemic.
  • No significant differences were observed in echocardiograms, LOS, or antibiotic timing between the phases.
  • Lab utilization returned to pre-pandemic levels, but increased ECG use continued post-peak.

Conclusions:

  • The COVID-19 pandemic led to increased utilization of laboratory tests and ECGs in hospitalized children, particularly during the peak.
  • Increased utilization of labs and ECGs during the peak may reflect heightened diagnostic uncertainty for certain bacterial infections.
  • While lab test ordering normalized, sustained increased ECG utilization warrants further investigation.