#46: Changes in the hospital admission profile in a Peruvian National Tertiary Children’s Hospital during the First Year of Covid-19 Pandemic

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Abstract Background During the first year of the current COVID-19 pandemic, health systems around the world have faced the challenge of maintaining health services for patients with non-communicable diseases, despite the logistical and personnel constraints. Despite SARS-CoV-2 infection is usually more benign in children, there is limited information about how this pandemic affected their healthcare at a population level. Methods We performed a cross sectional study at the Peruvian National Children′s Hospital San Borja, which is a 312-bed tertiary National referral health center, in Lima. We include all hospital admissions during 2020, with respect to the two previous years. We defined hospital admission as the permanence at the hospital for more than 24 hours irrespectively of patient′s initial destination (emergency observation unit, regular medical floor, or intensive care unit). We described demographic characteristics among hospitalized patients and compared them between 2018–19 and 2020 using standard descriptive tests. We use the International Classification of Diseases 10th (ICD-10) codes from the electronic patient registration system to ascertain three major non-communicable conditions: congenital cardiopathies, hematooncological disorders and burns non-communicable conditions. We set level for statistical significance at 0.05. Results There were 11635 patients admitted during 2018–19 period and 3480 patients admitted during 2020. The average daily hospital admission during 2018–19 was different compared to 2020 (15.9±6.1 vs. 9.6±6.0, p<0.001). There were also differences in the frequency of the gender (male 55.1% vs. 58.9%, p<0.001) and if the patient′s place of origin was outside Lima (49.0% vs. 41.1%, p<0.001). Among hospitalized patients, 3036 presented one of the three non-communicable conditions during the baseline period and 871 during 2020. There was a significant difference between the distribution of hospitalization among patients with one of the three non-communicable conditions (p<001), towards a decrease in hospitalizations due to congenital heart disease, and an increase in the hospitalizations due to burns. Conclusion During the first year of COVID-19 pandemic, there was a decrease in the number of hospitalizations of children with non-communicable conditions compared to the previous two years. It will be important to consider the implementation of public health policies aimed to increase accessibility to health care for children with non-communicable conditions during the coming months of the pandemic in Peru.