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Research Article: Impact of COVID-19 on the severity and length of stay among hospitalized pediatric patients

Date Published: 2026-08-31

Abstract:
Pediatric hospital admissions and emergency department visits decreased during the COVID-19 pandemic. The primary objective of this study was to determine if pediatric patients hospitalized during the pandemic were more severely ill compared with those during the pre-pandemic period by measuring severity of illness, intensive care unit admissions, and length of stay. A cross-sectional study was conducted of patients admitted to an urban, large children's hospital in the Mid-Southern US from 2016 to 2021. A total of 58,369 admissions were included, with 42,877 pre-pandemic and 15,492 pandemic admissions. During the pandemic, admissions of more severe illnesses increased significantly compared with pre-pandemic admissions. Intensive care unit admission rates increased during the pandemic (11%) compared with pre-pandemic levels (9.9%). Length of stay did not differ. The severity of illness for hospitalized pediatric patients increased significantly during the COVID-19 pandemic. The increase may stem from unmet medical needs; patients must still receive routine, acute, and chronic care.

Introduction:
On March 11, 2020, the World Health Organization (WHO) officially declared COVID-19 a pandemic ( 1 ). In response, governments and business entities placed restrictions on daily activities, affecting all facets of life, including travel, work, leisure activities, and access to routine medical care. From March 19 to April 2, 41 states issued “Stay-at-Home” orders ( 2 ). By late March and early April, more than 310 million Americans were under directives to shelter in place ( 3 ). Most major events worldwide were…

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