Faculty UCSD University of California San Diego San Diego, California, United States
Background: With the rapid spread of COVID-19, there remains uncertainty of how the pandemic will affect rates of pediatric illicit substance exposures. Some centers have reported increases in their rates of children hospitalized for pediatric drug ingestions. Nationally, the effect of COVID-19 on pediatric illicit substance exposures remains unknown.
Objective: To explore whether COVID-19 is affecting exposure to illicit drugs among young children.
Design/Methods: Using the Pediatric Health Information System, we compared emergency department, observation unit, and inpatient encounters for substance exposures in children ages 0-5 years. We identified these encounters through International Classification of Diseases 10th Revision diagnosis codes for cocaine, heroin, opioids, hallucinogens, amphetamines, cannabis, and benzodiazepine exposures. We excluded birth-related hospitalizations, NICU stays or complex care patients. We included encounters from January 2020 through June 2020 and from January 2019 through June 2019. We collected patient level data (sex, age, race, ethnicity, and insurance). Encounters from 2020 were compared to encounters from 2019. Absolute and relative frequencies were calculated. Chi-squared and two-proportion t-tests were used to compare the demographic characteristics for categorical and continuous data respectively. P-values <0.05 were considered statistically significant.
Results: From January to June 2019 there were 562 illicit substance encounters based on our defined cohort. During the same time period in 2020, there were 636 illicit substance encounters. In January and February of 2019, there were 194 encounters compared to 191 encounters in January and February of 2020 (prior to widespread COVID), representing a small relative decrease of 1.5% (95% CI: -4.5 to -0.32). From March to June of 2019, there were 368 encounters compared to 445 encounters from March to June of 2020 representing a 21% (95% CI: 16.9 to 25.4) relative increase in encounters for illicit substance exposures during COVID. There was no significant difference in patient-level characteristics. Conclusion(s): COVID-19 may be impacting illicit pediatric drug ingestions as shown by the overall relative increase in illicit substance exposure hospital encounters for March-June of 2020 compared to the year prior. This raises child protection concerns including illicit substance exposure and supervisional neglect. More data are needed over time to fully understand the impact of COVID-19 on pediatric substance exposures.
Authors/Institutions: Natalie Laub, University of California San Diego, La Jolla, California, United States; Colleen E. Bennett, Children's Hospital of Philadelphia, Philadelphia , Pennsylvania, United States; M. Katherine Henry, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States; Samantha Schilling, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States