Changes in Youth Cholesterol Screening Rates in an Academic Center During the COVID-19 Pandemic

Area of Science:

• Cardiology
• Public Health
• Pediatrics

Background:

• Conflicting guidelines on universal cholesterol screening in youth exist.
• Familial hypercholesterolemia in youth can lead to premature heart disease.
• The COVID-19 pandemic and guideline changes may have impacted youth cholesterol screening rates.

Purpose of the Study:

• To examine trends in youth cholesterol screening rates.
• To assess the impact of the COVID-19 pandemic and guideline updates on screening.
• To identify disparities in screening access.

Main Methods:

• Analysis of electronic health record data from a single academic institution.
• Calculation of cholesterol screening Order Placement Rates (OPRs) for individuals aged 8 years 9 months to 21 years.
• Categorization of study periods (pre-pandemic, pandemic stages, post-guideline) and demographic data (age, zip code, provider specialty).

Main Results:

• Cholesterol screening OPRs declined significantly post-pandemic and post-guideline update.
• The sharpest declines were observed in younger children (9-11 years) and among pediatric providers.
• Urban youth, particularly those in underserved areas, had higher screening rates than rural youth.

Conclusions:

• Both the COVID-19 pandemic and guideline updates led to decreased cholesterol screening in youth.
• Pediatric providers and younger children experienced the most substantial reductions in screening.
• Persistent disparities in access to youth cholesterol screening highlight the need for improved strategies.