Objective To evaluate the impact of COVID-19 on paediatric neurosciences healthcare utilisation

Methods Systematic literature review of studies evaluating the impact of COVID-19 on paediatric neuroscience provision (January 2020 - April 2022).

Findings 10474 papers were screened. Sixty-nine were eligible for inclusion. Studies were predominately from North America (33.3%; 23/69) and Europe (30.4%; 21/69). Epilepsy was the most common condition reported (47.8%; 33/69). 14.5% (19/69) studies made direct comparison between health utilisation or health seeking behaviour pre and during the pandemic. Key themes:- 1. Six studies (8.7%; 6/69) reported a reduction in emergency department attendance (range 24-72%). Eleven (15.9%; 11/69) studies reported either a cancellation or postponement of outpatient appointments (range 11-52%) 2. Twenty-four studies (34.8%; 24/69) reported changes in the severity of clinical conditions, of which 22 studies evaluated a percentage change. 23.3% reported worsening of the condition, 60.6% felt that there was no change, and 11.8% felt that there had been an improvement. 3. Thirty studies (43.5%; 30/69) reported on the expansion of telehealth (uptake range 24.5%-100%). Clinical effectiveness (range of 2.8%-100%) was reported in 11 studies (15.9%; 11/69). A negative impact (range 4.7%-36%) on clinical effectiveness was reported in 4 studies (5.7%; 4/69). The negative impact (range 15.7%-50%) on cost effectiveness was reported in 2 studies (2.9%; 2/69).

Conclusion: There was a reduction in emergency health utilisation and outpatient provision in paediatric neurosciences, up to 72% and up to 52% respectively. Over 20% reported an increase in symptom severity despite rapid telehealth expansion, independent of COVID-19 infection.

Sarah Grantham-Hill
Evelina Children’s Hospital
United Kingdom

Anisa Uddin
Evelina Children’s Hospital
United Kingdom

Jo Wilmhurst
University of Cape Town
South Africa

Ming Lim
Evelina Children’s Hospital
United Kingdom

Saraswathy Sabanathan
Evelina Children’s Hospital
United Kingdom