The Pattern of Hospital Admission For Respiratory Tract Infection before and during the COVID-19 pandemic In A Tertiary Hospital, Malaysia

Introduction: The main measure to combat the COVID-19 pandemic in Malaysia was the implementation of movement control order (MCO) in March 2020. This pandemic changed lifestyles, including children, which affects the illnesses among them.Aim: To determine the changes in hospital admission patterns for respiratory tract infection among paediatric patients before and during the COVID-19 pandemic. Methodology: The study was conducted in Hospital Tunku Azizah, Kuala Lumpur, a tertiary paediatric non-COVID hospital. All cases admitted to General paediatric wards from April 2019 to June 2020 were identified from the electronic Hospital Information System (HIS). Characteristics of admissions before and during the COVID-19 pandemic were compared. Results: 4292 admissions were analyzed. The patients' median age was 19 months (IQR 9-41 months) before the pandemic, and it has reduced to 16 months (IQR 7-44 months) during the pandemic. There was a significant reduction in the number of admissions during MCO (from 420 admissions/month to 40 admissions/month). Pneumonia remains the commonest reason for admission before and during the pandemic. However, the proportion of pulmonary tuberculosis has increased significantly from 1.3% before the pandemic to 5% during the pandemic. There is no significant difference in gender, race, nationality, day of admissions, admission times, and admissions duration before and during the pandemic. Conclusion: The study showed, although MCO was implemented, respiratory tract infections remained the commonest diagnosis. Increased percentage of pulmonary tuberculosis cases during the pandemic is a concern and warrant further evaluation. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest The authors declare no conflict of interests. References and Clinical Trial Registry Information References:Schuez-Havupalo, L., Toivonen, L., Karppinen, S., Kaljonen, A., & Peltola, V. (2017). Daycare attendance and respiratory tract infections: a prospective birth cohort study. BMJ open, 7(9), e014635. https://doi.org/10.1136/bmjopen-2016-014635.World Health Organization (WHO). (2020). World Health Organization (WHO) Information Note Tuberculosis and COVID-19. https://www.who.int/docs/default-source/hq-tuberculosis/covid-19-tb-clinical-management-info-note-dec-update-2020.pdf?sfvrsn=554b68a7_0#:~:text=People%20ill%20with%20COVID%2D19,often%20with%20a%20slow%20onset.