Inpatient Profile Evaluations Regarding a Pediatric Nephrology Unit Pre-Covid-19 and During

Öz

Objective: The COVID-19 pandemic has caused a routine non-clinical course due to primary COVID-19 infection and affected non-COVID patients’ access to healthcare services. This study aims to evaluate the changes in hospitalization diagnoses of patients admitted to a nephrology unit before and during the COVID-19 pandemic. Methods: The study evaluates the inpatients admitted between March 2018- 2020 and March 2020-2022 in the Nephrology Unit of Izmir Behçet Uz Pediatrics and Surgery Training and Research Hospital, University of Health Sciences. Results: This study includes a total of 1,453 patients. Of these patients, 882 were hospitalized in the pre-COVID period, and 571 were hospitalized during the pandemic. Although a significant difference occurs between genders, no significant differences were found in terms of age and length of stay. The most common diagnoses pre-COVID were urinary tract infections (UTI; 40.1%), nephrotic syndrome (NS; 12.9%), chronic kidney diseases (CKDs; 10.3%), and hypertension (HT; 10%). This order after the pandemic was UTI (35.7%), CKDs (20.8%), NS (10.7%), and HT (10.2%). A significant increase occurred regarding the frequency of CKDs post-pandemic (p = 0.000) and the frequency of hematuria pre-pandemic (p = 0.025). Conclusions: The study is important for being the only study conducted in the field of pediatric nephrology regarding the changes in pandemic hospitalizations. During the pandemic, hospitalizations of chronic patients increased, and hospitalizations of examination patients decreased due to the postponement of elective conditions. What is noteworthy is the decreased incidence of upper respiratory tract infections (URTI) and Henoch-Schönlein purpura (HSP), which are known to trigger nephrotic syndrome and glomerulonephritis. Another remarkable result is the decreased number of patients with recurrent UTIs. Although a decrease did occur in this group, the frequency of UTIs actually increased in general pediatric applications, which led to the emergence of missed diagnoses pre-pandemic.

Anahtar Kelimeler

• Pediatric nephrology
• COVID-19 pandemic
• inpatient profile

Kaynakça

1. Goichberg J, Becker-Cohen R. Pediatric Nephrology in The Time of Corona. Harefuah. 2021 Dec;160(12):780-785 google scholar
2. Wilder, J. L., Parsons, C. R., Growdon, A. S., Toomey, S. L., & Mansbach, J. M. Pediatric Hospitalizations During the COVID-19 Pandemic. Pediatrics, e2020005983. doi:10.1542/peds.2020-005983 10.1542/peds.2020-005983 google scholar
3. Yuanyuan D, Xi M, Yabin H, Xin Q, Fan J, Zhongyi J, et al. Epidemiology of COVID-19 Among Children in China. Pediatrics June 2020; 145 (6) doi:10.1542/peds.2020-0702 google scholar
4. Raina R, Nair N, Sharma A, Chakraborty R, Rush S; Delphi Panelists. Telemedicine for Pediatric Nephrology: Perspectives on COVID-19, Future Practices, and Work Flow Changes. Kidney Med. 2021 May-Jun;3(3):412-425 doi:10.1016/j.xkme.2021.01.007 google scholar
5. Tse Y, Darlington AE, Tyerman K, Wallace D, Pankhurst T, Chantziara S, et al. COVID-19: experiences of lockdown and support needs in children and young adults with kidney conditions. Pediatr Nephrol. 2021 Sep;36(9):2797-2810. doi: 10.1007/s00467-021-05041-8 google scholar
6. Iyer KS. Impact of the COVID-19 pandemic on pediatric cardiac care in India: time for action. Ann Pediatr Cardiol. 2020; 13: 183-5 doi: 10.4103/apc.APC_153_20 google scholar
7. O’Neill WC. Renal relevant radiology: use of ultrasound in kidney disease and nephrology procedures. Clin J Am Soc Nephrol. 2014 Feb;9(2):373-81. doi: 10.2215/CJN.03170313 google scholar
8. Dhull RS, Joshi A, Saha A. Nuclear Imaging in Pediatric Kidney Diseases. Indian Pediatr. 2018 Jul 15;55(7):591-597 doi:10.1007/ s13312-018-1303-7 google scholar

9. Canpolat N. COVID-19 and the kidney. Turk Arch Pediatr. 2021 Feb 3;56(2):97-98. doi: 10.5152/TurkArchPediatr.2021.150121 google scholar
10. Genel Bilgiler, Epidemiyoloji ve Tanı. Erişim adresi: https://covid19. saglik.gov.tr/TR-66337/genel-bilgiler-epidemiyoloji-ve-tani.html google scholar
11. Parasher A. COVID-19: Current understanding of its Pathophysiology, Clinical presentation and Treatment. Postgrad Med J. Mayıs 2021;97(1147):312-20. doi.org/10.1136/ postgradmedj-2020-138577 google scholar
12. Ramos-Lacuey B, Herranz Aguirre M, Calderon Gallego C, Ilundain Lopez de Munain A, Gembero Esarte E, Moreno-Galarraga L. ECIEN-2020 study: the effect of COVID-19 on admissions for non-COVID-19 diseases. World J Pediatr. 2021;17(1):85-91. doi:10.1007/s12519-020-00406-9 google scholar
13. Alfonso Viguria U, Casamitjana N. Early Interventions and Impact of COVID-19 in Spain. Int J Environ Res Public Health. 2021 Apr 12;18(8):4026. doi: 10.3390/ijerph18084026. PMID: 33921238; PMCID: PMC8068943 google scholar
14. Dann L, Fitzsimons J, Gorman KM, Hourihane J, Okafor I. Disappearing act: COVID-19 and paediatric emergency department attendances. Arch Dis Child. Ağustos 2020;105(8):810-1. doi:10.1136/archdischild-2020-319654 google scholar
15. Canlı A. COVID-19 Pandemisi Öncesi Ve Covıd-19 Pandemisi Sırasında Genel Pediatri Servislerinde 4-17 Yaş Arasi Yatan Çocuklarin Yatiş Sikliği Ve Yatan Hasta Profili Değişiminin Değerlendirilmesi. T.C. Sağlik Bilimleri Üniversitesi İzmir Dr. Behçet Uz Çocuk Hastaliklari Ve Cerrahisi Sağlik Uygulama Ve Araştirma Merkezi Çocuk Sağliği Ve Hastaliklari Eğitim Kliniği. Uzmanlik Tezi. 2022 google scholar
16. Pars H. COVID-19 Pandemisinde Çocuklar ve Pediatri Hemşiresinin Rolleri. Hacet Üniversitesi Hemşire Fakültesi Derg. 29 Temmuz 2020;66-75. google scholar
17. Alataş Ö.D.,Gökçek K.Comparison of Patients Admitted to The Emergency Department During and Before the Pandemic Period. Medical Journal of Mugla Sitki Kocman University 2021;8(3):195-198 google scholar
18. Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The Impact of the COVID-19 Pandemic on Hospital Admissions in The United States. Health Aff (Millwood). 2020;39(11):2010-2017. doi:10.1377/hlthaff.2020.00980 google scholar