Aim:

COVID-19 related non-pharmaceutical interventions (NPIs) dramatically reshaped global healthcare utilisation, leading to sharp declines in infectious disease related hospitalisations amongst children. The impact of NPIs on non-infectious paediatric conditions is less well understood. We aimed to identify which non-infectious paediatric conditions increased in incidence during the introduction and alleviation of NPIs in 2020.

Methods:

We examined anonymous hospitalisation data from Perth's sole tertiary paediatric hospital (Jan 2015–Dec 2020), according to pre-defined age groups (0–4 years, 5–9 years, 10–16 years and 0–16). We identified the non-infectious diagnoses which were admitted most frequently amongst these age groups over five different NPI periods. Interrupted time series analysis was performed to compare observed versus expected admission rates for the major non-infectious diagnosis groups (perinatal disorders, mental disorders). 

Results:

Following implementation of NPIs, overall paediatric admissions fell by 30% during the strictest NPIs, before quickly rebounding to pre-pandemic levels by mid-2020. Weekly admission rates for perinatal disorders amongst 0–4 year-olds increased by 18% (IRR = 1.18 [95% CI: 1.04–1.35]). ITS analysis revealed non-significant changes in weekly admissions for mental disorders in 10–16 -year-olds (IRR = 0.91 [95% CI: 0.79–1.06]). The incidence of eating disorders, however, increased significantly following the introduction of NPIs (IRR = 1.60 [95% CI: 1.14–2.25]).

Conclusions:

Changes in admissions for perinatal disorders and eating disorders highlight the unintended impact of COVID-19 associated NPIs on paediatric health. Amongst mental disorders more generally, it is possible that admission rates in 2020 may have been greater had COVID-19 associated NPIs not disrupted pre-pandemic trends. These findings aid our understanding of social factors mediating paediatric disease and may improve healthcare delivery in a post-pandemic era.

Dr Mitchell Pratt is a clinical researcher affiliated with the School of Medicine at the University of Western Australia (UWA). His interests centre on the intersection between population health and paediatric wellbeing, with a focus on examining how social and environmental factors shaped child health outcomes during the COVID-19 pandemic. Mitchell currently serves as a medical registrar at Royal Darwin and Palmerston Hospitals in the Northern Territory, Australia. 

Mitchell completed his medical degree (Doctor of Medicine) at the University of Western Australia and undertook research with the Kids Research Institute Australia whilst at university.

Mitchell was first author of The Unintended Impact of COVID-19 Associated Non-Pharmaceutical Interventions on Paediatric Hospital Admissions, published in the Journal of Paediatrics and Child Health (2025), which explores how pandemic control measures influenced non-infectious paediatric admissions at Perth Children’s Hospital. His work contributes to the growing body of evidence informing post-pandemic recovery planning and health system resilience. His other publications include Prevalence of respiratory viruses in community-acquired pneumonia in children: a systematic review and meta-analysis, published in the Lancet Child and Adolescent Health (2022).