Safety Events in Children's Hospitals During the COVID-19 Pandemic

Hosp Pediatr. 2021 Jun;11(6):e95-e100. doi: 10.1542/hpeds.2020-004937. Epub 2021 May 6.


Background and objectives: The coronavirus disease 2019 (COVID-19) pandemic has impacted hospitals, potentially affecting quality and safety. Our objective was to compare pediatric hospitalization safety events during the pandemic versus previous years.

Methods: In this retrospective cohort study of hospitalizations in the Pediatric Health Information System, we compared Pediatric Quality Indicator (PDI) rates from March 15 to May 31, 2017-2019 (pre-COVID-19), with those from March 15 to May 31, 2020 (during COVID-19). Generalized linear mixed-effects models with adjustment for patient characteristics (eg, diagnosis, clinical severity) were used.

Results: There were 399 113 discharges pre-COVID-19 and 88 140 during COVID-19. Unadjusted PDI rates were higher during versus pre-COVID-19 for overall PDIs (6.39 vs 5.05; P < .001). In adjusted analyses, odds of postoperative sepsis were higher during COVID-19 versus pre-COVID-19 (adjusted odds ratio 1.28 [95% confidence interval 1.04-1.56]). The remainder of the PDIs did not have increased adjusted odds during compared with pre-COVID-19.

Conclusions: Postoperative sepsis rates increased among children hospitalized during COVID-19. Efforts are needed to improve safety of postoperative care for hospitalized children.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • COVID-19 / epidemiology*
  • Causality
  • Child
  • Child, Preschool
  • Cohort Studies
  • Comorbidity
  • Female
  • Hospitalization
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • Infant
  • Male
  • Pandemics
  • Patient Safety / statistics & numerical data*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • SARS-CoV-2
  • Sepsis / epidemiology*
  • United States / epidemiology