Department of Pediatrics, National Taiwan University Children's Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Surgery, National Taiwan University Children's Hospital and National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2023 Feb;122(2):113-120. doi: 10.1016/j.jfma.2022.09.011. Epub 2022 Sep 23.
BACKGROUND/PURPOSE: Coronavirus disease 2019 (COVID-19) pandemic challenges pediatric health globally by limited medical accessibility. In response to COVID-19 epidemic in Taiwan, public restrictions were applied and the Level 3 alert was announced from May to July in 2021 for local outbreak. This study aims to analyze patients' clinical features and outcomes in the pediatric intensive care unit (PICU) during the COVID-19 epidemic with the Level 3 alert in Taiwan.
Medical records were retrospectively collected in patients admitted to the PICU of National Taiwan University Children's Hospital from May to July 2021 (Level 3 alert) and May to July 2019 and 2020 (control periods). Clinical characteristics and outcomes were compared between patients in the period with the Level 3 alert and control periods.
During the study period, PICU monthly admissions significantly decreased in the Level 3 alert period and were negatively correlated with monthly newly confirmed COVID-19 cases. Patients admitted during the Level 3 alert were older, had higher disease severity, lower proportion of cardiovascular disease, and higher proportion of hematology-oncology diseases than those in the control group. After adjusting for the above factors, admission during Level 3 alert was an independent factor for higher mortality rate and prolonged length of stay (>14 days) in the PICU.
During the COVID-19 epidemic with strict public restrictions, critically ill patients admitted to the PICU decreased but had increased disease severity, prolonged length of stay in the PICU, and higher mortality, reflecting the impact of quarantine and limited medical access.
背景/目的：新冠肺炎（COVID-19）大流行通过有限的医疗可及性对全球儿科健康构成挑战。为应对台湾 COVID-19 疫情，2021 年 5 月至 7 月，台湾实施了公众限制措施，并宣布当地疫情为 3 级警报。本研究旨在分析 COVID-19 疫情期间台湾 3 级警报下儿科重症监护病房（PICU）患者的临床特征和结局。
回顾性收集了 2021 年 5 月至 7 月（3 级警报期）和 2019 年、2020 年同期（对照组）入住国立台湾大学儿童医院 PICU 的患者的病历。比较 3 级警报期和对照组患者的临床特征和结局。
在研究期间，3 级警报期 PICU 每月入院人数明显减少，且与每月新确诊的 COVID-19 病例数呈负相关。与对照组相比，3 级警报期入院的患者年龄较大，疾病严重程度较高，心血管疾病比例较低，血液肿瘤疾病比例较高。在校正上述因素后，3 级警报期入院是 PICU 死亡率较高和住院时间延长（>14 天）的独立因素。
在严格的公众限制措施下，COVID-19 大流行期间，入住 PICU 的危重症患者减少，但疾病严重程度增加，PICU 住院时间延长，死亡率更高，反映了隔离和有限的医疗可及性的影响。
