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May 22, 2021
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COVID-19, increased foreign body ingestions among children

Stay-at-home orders amid COVID-19 correlated with and increased frequency of foreign body ingestions among a pediatric cohort, according to a study presented at Digestive Disease Week.

“The rate of foreign body ingestions amongst children is a common problem and the rate of ingestion is increasing over time. While some foreign bodies pass without incident, others can cause serious harm such as bowel perforation, fistulas and death,” Katherine Black, MD, Vanderbilt University Medical Center, said. “At the beginning of the COVID pandemic, many schools went to virtual learning. ... Parents and guardians became full-time caregivers and teachers, all while trying to maintain full productivity while working from home. These changes to routines may have altered risk factors for foreign body ingestion.”

In a retrospective analysis, researchers evaluated foreign body ingestion encounters from the electronic health records at a tertiary care children’s hospital from March 2019 to July 2019 (pre-COVID) and March 2020 to July 2020 (COVID). Of 72 foreign body ingestions, 30 ingestions occurred in the pre-COVID cohort vs. 43 ingestions in the COVID cohort. The median age at presentation was similar between cohorts (63.8 months vs. 62.6 months, respectively) with boys ingesting foreign bodies more frequently (63%). According to initial X-ray data, esophageal foreign bodies were more common in the pre-COVID cohort vs. the COVID cohort, endoscopy was performed less frequently among patients with COVID (53.5% vs. 70%; OR = 0.49; 95% CI, 0.16-1.45).

“Foreign body ingestion was significantly higher during COVID in May 2020 compared to May 2019 and endoscopic retrieval of foreign bodies occurred less frequently,” Black concluded. “Anticipatory guidance should continue to be given to caregivers to prevent further foreign body ingestion with emphasis that, during this time of caregivers' multitasking, the risk of foreign body ingestion may be higher than observed prior.”