621 - Assessing the Frequency of Children Evaluated for Recurrent Fevers and Suspected Autoinflammatory Diseases During the COVID-19 Pandemic in North America

Poster Number: 621
Publication Number: 621.200

Leanne M. Mansfield, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY, United States; Sivia K. Lapidus, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Hackensack, NJ, United States; Julie Cherian, Stonybrook University Hospital, Stony Brook, NY, United States; Marinka Twilt, University of Calgary, Calgary, AB, Canada; Maryam Piram, CHU Sainte Justine, University of Montreal, Montreal, PQ, Canada; Lakshmi N. Moorthy, Rutgers, Robert Wood Johnson Medical School, Metuchen, NJ, United States; Brian E. Nolan, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Geraldina Lionetti, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States; Eveline Wu, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States; Heather O. Tory, Connecticut Children's Medical Center and University of Connecticut School of Medicine, Hartford, CT, United States; Elizabeth A. Kessler, Helen DeVos Children's Hospital, Grand Rapids, MI, United States; Cassyanne L. Aguiar, Children’s Hospital of The King’s Daughters / Eastern Virginia Medical School, Norfolk, VA, United States; Sirada Panupattanapong, Cleveland Clinic Children's, Cleveland, OH, United States; Shoghik Akoghlanian, Nationwide Children's Hospital, Columbus, OH, United States; Felice C. Adler-Shohet, University of California, Irvine and CHOC, Seal Beach, CA, United States; Melissa Oliver, Indiana University School of Medicine, Indianapolis, IN, United States; Smriti Mohan, University of Michigan Medical School, Ann Arbor, MI, United States; Patricia DeLaMora, New York Medical College, Valhalla, NY, United States; Karen L. Durrant, Autoinflammatory Alliance, San Francisco, CA, United States; Theresa Wampler Muskardin, New York University Grossman School of Medicine, New York, NY, United States; Karen B. Onel, Weill Cornell Medicine, New York, NY, United States; Samira Nazzar Romero, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, United States; Mariana Correia Marques, Children's National Health System, Washington, DC, United States; Johnathan Dallas, Boston Children's Hospital, Boston, MA, United States; Fatma Dedeoglu, Boston Children's Hospital, Waban, MA, United States; Maria J. Gutierrez, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Grant Schulert, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; CARRA PFAPA/Autoinflammatory Working Group, CARRA, Milwaukee, WI, United States

Background: The impact of the COVID-19 pandemic on the number of pediatric patients presenting in North America with recurrent fevers and autoinflammatory diseases is unknown; however, there have been reports of increasing numbers of children presenting with these diseases.

Objective: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) Autoinflammatory Disease Network Development Work Group examined the number of new patients evaluated for recurrent fevers in temporal relation to the COVID-19 pandemic in North America.

Design/Methods: The CARRA Autoinflammatory Disease Network includes specialists in pediatric rheumatology, infectious diseases, and immunology as well as parents/patients and members of the Autoinflammatory Alliance. Recurrent fever diagnoses, including periodic fever and autoinflammatory syndromes, were assessed via ICD-10 codes. Monthly numbers of new patients with recurrent fever diagnoses seen by outpatient subspecialists were collected from March 1, 2019 to February 29, 2020 (pre-pandemic) and from March 1, 2020 to February 28, 2021 (during the pandemic). The proportion of new visits with recurrent fever diagnoses relative to all new visit diagnoses during these two years were compared using a two-sample test of proportions.

Results: Fifteen sites reported 1072 new patient visits with recurrent fever diagnoses pre-pandemic compared with 1233 during the first year of the pandemic. There was an increase in the total number of recurrent fever diagnoses after the onset of the pandemic compared to the year prior in 12 of 15 sites (range -48%-123%). Of the 9 sites who provided the total number of new visits for all diagnoses, there were 9715 new visits pre-pandemic of which 482 (4.96%) had a recurrent fever diagnosis compared to 8233 new visits during the pandemic with 562 (6.83%) who received a recurrent fever diagnosis. The difference between the proportion of new recurrent fever diagnoses and total number of new visits pre-pandemic versus during the pandemic was statistically significant (p < 0.0001).Conclusion(s): There was an increase in patients with recurrent fever diagnoses during the first year of the COVID-19 pandemic, despite both a decrease in the total number of new patients and increased infection control precautions during the pandemic. This finding suggests infections are less likely to be triggering recurrent fever syndromes. The CARRA Autoinflammatory Disease Network’s project is the first collaborative, multidisciplinary effort to assess the number of children evaluated for recurrent fevers in relation to the COVID-19 pandemic in North America.
Locations of Participating Pediatric Subspecialty Sites in North America
New Recurrent Fever Diagnoses Pre and Post COVID-19 Pandemic Onset at Fifteen North American Pediatric Subspecialty Sites