Children who received surgery during the first part of the COVID-19 pandemic in 2020 developed life-threatening sepsis at higher rates than pre-pandemic, according to new research out in the journal Hospital Pediatrics.
Study authors are calling for more efforts to improve the safety of care for children post-surgery, especially as health officials estimate the pandemic is not over.
"In light of the ongoing pandemic and morbidity and mortality associated with postoperative sepsis, efforts are needed to further understand this alarming finding to mitigate risk for children requiring surgery during the COVID-19 pandemic," wrote the authors from the University of Missouri – Kansas, the Children's Hospital Association, the University of California at San Francisco and other organizations.
The sepsis complications were associated the most with serious surgeries like organ transplants, heart assistance device implantations and chest drainage procedures.
The researchers were only able to guess at the reasons for higher rates of sepsis, which might include overall delays in parents getting their kids to the doctor because of the pandemic, which led to delays in diagnosis and more severe disease states when surgeries finally happened.
"It is also conceivable that changes in workflow and personnel and need for personal protective equipment for hospital staff could lead to delays in postoperative management," the authors state. "This could lead to delayed recognition and treatment of hospital acquired infections that could then progress to sepsis."
The study took data representing about 20% of pediatric hospitalizations from 45 children's hospitals, also known as the Pediatric Health Information System compiled by the Children's Hospital Association. They compared more than 88,000 hospital discharge claims between Mary and May of 2020 to more than 300,000 discharges in the same months but between 2017 and 2019.
Pediatric Quality Indictors — which identify potentially preventable events — were then extrapolated for both time frames. Even after study authors risk adjusted for how sick children were when they presented at the hospital, there was a 28% increase in sepsis cases.
"Given the concern that the COVID-19 pandemic will persist for months to years, as well as concern for risk of future pandemics, continued efforts are warranted to ensure the safety of hospitalized children," the researchers summarized.
The study in part was supported by grants from the Agency for Healthcare Research and Quality.