University of Wisconsin–Madison Medical College of Wisconsin

Changes in Pediatric Intensive Care Admissions in Wisconsin During the 2020 COVID-19 Pandemic

Claire Godsey, MD; Rachel Gabor, MS; Matthew Oelstrom, MD; Scott Hagen, MD; Jennifer Peterson, MD; John Taylor, DO; Theresa Mikhailov, MD, PhD

WMJ. 2022;121(3):194-200

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Background: We perceived changes in the frequency of and reasons for admissions to Wisconsin pediatric intensive care units (PICU) during the advent of the COVID-19 pandemic, and we hypothesized that the rates of total, scheduled, and respiratory viral admissions were lower during the first calendar year of the pandemic than would have been predicted by historical admission data. Such findings would reflect important changes in PICU utilization paradigms during the pandemic. There are no descriptions of PICU admission changes in a single American state during the pandemic.

Methods: We compared all Wisconsin PICU admissions during the COVID-19 pandemic in 2020 (the study epoch) to admissions in seasonally matched, growth-adjusted “no-COVID-19” projections generated by time series analysis of all Wisconsin PICU admissions in the previous 5 years (the control epoch).

Results: We identified 27,425 PICU admissions with 294,577 associated diagnoses in the study and control epochs. Total admissions were 60 ± 9 week-1 in the study epoch versus 103 ± 4 projected (RR 0.63; 95% CI, 0.59-0.68; P < 0.001). Scheduled admissions were 17 ± 6 week-1 in the study epoch versus 28 ± 3 projected (RR 0.61; 95% CI, 0.55-0.67; P < 0.001). Respiratory viral admissions were 8 ± 5 week-1 in the study epoch versus 19 ± 9 projected (RR 0.40; 95% CI, 0.33-0.48; P < 0.001). Some admission categories experienced dramatic declines (c, respiratory/ear, nose, throat), while others experienced less decline (eg, injury/poisoning/adverse effects) or no significant change (eg, diabetic ketoacidosis). Except cases of COVID-19, no category had significantly increased weekly admissions. There were 104 admissions associated with COVID-19 diagnoses in 2020, 4.3% of the study epoch admissions.

Conclusions: We describe PICU admission changes in the first calendar year of COVID-19, informing health care staffing and service planning, as well as decisions regarding strategies to combat the evolving pandemic.

Author Affiliations: Marshfield Clinic Health System, Marshfield, Wisconsin (Godsey); Department of Biostatistics, Marshfield Clinic Research Institute, Marshfield, Wis (Gabor); Pediatric Intensive Care Unit, Marshfield Children’s Hospital, Marshfield, Wis (Oelstrom); Department of Pediatrics, University of Wisconsin School of Medicine and Public Health and Pediatric Intensive Care Unit, American Family Children’s Hospital, Madison, Wis (Hagen); Pediatric Intensive Care Unit, Gundersen Lutheran Medical Center, La Crosse, Wis (Peterson); Prevea Health and Pediatric Intensive Care Unit, HSHS St. Vincent Hospital-Green Bay, Green Bay, Wis (Taylor); Department of Pediatrics, Medical College of Wisconsin and Pediatric Intensive Care Unit, Children’s Wisconsin, Milwaukee, Wis (Mikhailov).
Corresponding Author: Matthew J. Oelstrom, MD, Marshfield Children’s Hospital-H3W, 1000 N Oak Ave, Marshfield, WI 54449; phone 262.352.2875; email; ORCID ID 0000-0001-8574-5121.
Financial Disclosures: Dr Mikhailov provides database consultation to VPS, LLC, but receives no money for this activity. The Medical College of Wisconsin receives support for her services from VPS, LLC.
Funding/Support: This project was supported by Marshfield Clinic Health System resident research funding from the Division of Education.
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