O-12 Trends in respiratory diseases in the emergency room visits in children and the impact of the COVID-19 pandemic. A hospital-based retrospective study in Jamaica 2019–2022

Methods: This is a retrospective cohort study of ER visits among children 0-19 at a tertiary care hospital in Jamaica from September- December of 2019 (pre-, lockdown), 2020 (lockdown), and 2022 (post-lockdown). Demographic data was collected from the digital database and registers for asthma, and lower and upper respiratory tract infections (URTI) visits. Variables include sex and age, and asthmarelated admissions. The lab database was reviewed for SARSCOV-2 positivity rate (2020–2022) and other circulating viruses (2019–2022). Comparisons were made between periods using Fisher’s exact tests.

Results: There were a total of 2532 visits to the emergency room for respiratory diseases in children 0-19 years due to asthma (69%), pneumonia (20%), and URTI (11%), with 57% males. Post-lockdown, there was a one-fold and four-fold increase in the under five-year age visits compared with pre-lockdown and lockdown (p=0.0001). The proportion of asthma-related visits increased by 72 % postlockdown from 59% during lockdown (p=0.013). Asthmarelated admissions were 3.6 % in 2019, 4.6% in 2020, and 4.5% in 2022. H3N2 influenza virus was predominant in 2019, SARSCov-2 in 2020, and SARSCoV-2 and H3N2 in 2022.SARSCOV-2 positivity rate was 4%, 17%, and 8% in 2020,2021 and 2022

Conclusion: Asthma visits but not severity resurged postlockdown. Increased ER visits for children under age five years post-lockdown compared with pre-lockdown with similar H3N2 circulation may signal attenuated respiratory disease manifestation due to the COVID-19 pandemic.