346 - The Prevalence of Pneumonia Before and After Implementation of Coronavirus Disease 19 (COVID-19) Non-pharmalogical Interventions in the Pediatric Emergency Department

Poster Number: 346
Publication Number: 346.204

Jennifer Allen, Akron Children's Hospital, Akron, OH, United States; Kailey A. Remien, Akron Children's Hospital, Akron, OH, United States; Osama El-Assal, Akron Children's Hospital, Akron, OH, United States; Scott Pangonis, Akron Children's Hospital, Akron, OH, United States; Anne Hall, Akron Children's Hospital, Akron, OH, United States

Background: Community-acquired pneumonia (CAP) is a leading cause of death in children worldwide and is more prevalent during the respiratory season. The role of social distancing and mask utilization in prevention of CAP spread is unclear.

Objective: This study evaluates the prevalence of CAP before and after implementation of COVID-19 precautions in our community during 2019-2020 season.

Design/Methods: This is a retrospective cohort study conducted at Akron Children’s Hospital, Ohio where the peak respiratory season extends from October to April. The primary outcome was the prevalence of Emergency Department (ED) diagnosis of pneumonia after non-pharmalogical interventions during the COVID pandemic (social distancing, masking, school closures, and limiting travel) (October 2020-April 2021), compared with the two pre-COVID-19 seasons (2018-2019 and 2019-2020). Diagnosis of pneumonia was based on clinical presentation and radiologic imaging. Laboratory assays for bacterial targets of CAP (Bordetella pertussis, Bordetella parapertussis, Mycoplasma pneumoniae, and Chlamydia pneumoniae) were also evaluated during the same study period (Table 1). Chi-square test or Fisher's exact test was used to analyze categorical data; Wilcoxon test or Student's t-test were used to analyze continuous data.

Results: The number of patients diagnosed with pneumonia in the ED dramatically declined following the COVID-19 social distancing measures (2020-2021, Nf 133), compared with 1134 (2018-2019), and 1335 (2019-2020) patients during the pre-COVID-19 seasons (Figure 1). There was a significant increase in RFA testing and overall testing for bacterial targets of pneumonia during COVID-19 pandemic. However, no cases of M. pneumonia, B. pertussis, or B. pertussis were detected following social distancing implementations compared to totals of 43 and 96 cases in previous seasons. In contrast, there was no significant change in the incidence of Chlamydia pneumoniae, which is not thought to be transmitted via droplet or airborne methods. (Table 2)Conclusion(s): Social distancing and mask mandates can be effective tools to decrease the rates of CAP among the pediatric population and may be considered for protection of the vulnerable patient populations.
Jennifer Allen CVCV J Allen.pdf
Table 2Results of PCR testing for bacterial pneumonia targets