Increase in Pediatric Recurrent Fever Evaluations During the First Year of the COVID-19 Pandemic in North America

Authors

• Leanne M. Mansfield, Department of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States.
• Sivia K. Lapidus, Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center and Hackensack Meridian Health, Hackensack, NJ, United States.
• Samira Nazzar Romero, Department of Rheumatology, Nemours Children's Hospital, Orlando, FL, United States.
• Lakshmi N. Moorthy, Department of Pediatrics, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States.Follow
• Felice C. Adler-Shohet, Harbor UCLA Medical Center, University of California, Irvine, CA, United States.Follow
• Matthew Hollander, Department of Pediatrics, University of Vermont Larner College of Medicine, Burlington, VT, United States.
• Julie Cherian, Department of Pediatrics, Stony Brook Children's Hospital, Stony Brook, NY, United States.
• Marinka Twilt, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada.
• Geraldina Lionetti, Department of Pediatrics, University of California San Francisco, Benioff Children's Hospitals, San Francisco, CA, United States.
• Smriti Mohan, Department of Pediatrics, University of Michigan, CS Mott Children's Hospital, Ann Arbor, MI, United States.
• Patricia A. DeLaMora, Department of Pediatrics, New York Medical College, Valhalla, NY, United States.
• Karen L. Durrant, Autoinflammatory Alliance, San Francisco, CA, United States.
• Theresa Wampler Muskardin, Department of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States.
• Mariana Correia Marques, National Institute for Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, United States.
• Karen B. Onel, Department of Pediatric Rheumatology, Hospital for Special Surgery, New York, NY, United States.
• Fatma Dedeoglu, Division of Immunology, Department of Medicine, Boston Children's Hospital, Boston, MA, United States.
• Maria J. Guttierez, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
• Grant Schulert, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Author Type(s)

Faculty

DOI

10.3389/fped.2023.1240242

Journal Title

Frontiers in Pediatrics

First Page

1240242

Document Type

Article

Publication Date

1-1-2023

Department

Pediatrics

Keywords

CARRA, COVID-19, fevers, pediatric, recurrent, rheumatology

Disciplines

Medicine and Health Sciences

Abstract

The impact of the COVID-19 pandemic on new diagnoses of recurrent fevers and autoinflammatory diseases is largely unknown. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) PFAPA/AID Working Group aimed to investigate the impact of the COVID-19 pandemic on the number of pediatric patients evaluated for recurrent fevers and autoinflammatory diseases in North America. The absolute number of new outpatient visits and the proportion of these visits attributed to recurrent fever diagnoses during the pre-pandemic period (1 March 2019-29 February 2020) and the first year of the COVID-19 pandemic (1 March 2020-28 February 2021) were examined. Data were collected from 27 sites in the United States and Canada. Our results showed an increase in the absolute number of new visits for recurrent fever evaluations in 21 of 27 sites during the COVID-19 pandemic compared to the pre-pandemic period. The increase was observed across different geographic regions in North America. Additionally, the proportion of new visits to these centers for recurrent fever in relation to all new patient evaluations was significantly higher during the first year of the pandemic, increasing from 7.8% before the pandemic to 10.9% during the pandemic year ( < 0.001). Our findings showed that the first year of the COVID-19 pandemic was associated with a higher number of evaluations by pediatric subspecialists for recurrent fevers. Further research is needed to understand the reasons behind these findings and to explore non-infectious triggers for recurrent fevers in children.

Recommended Citation

Mansfield, L. M., Lapidus, S. K., Romero, S. N., Moorthy, L. N., Adler-Shohet, F. C., Hollander, M., Cherian, J., Twilt, M., Lionetti, G., Mohan, S., DeLaMora, P. A., Durrant, K. L., Muskardin, T. W., Correia Marques, M., Onel, K. B., Dedeoglu, F., Guttierez, M. J., & Schulert, G. (2023). Increase in Pediatric Recurrent Fever Evaluations During the First Year of the COVID-19 Pandemic in North America. Frontiers in Pediatrics, 11, 1240242. https://doi.org/10.3389/fped.2023.1240242