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  • Increased incidence of severe nutritional anaemia in Yorkshire and Humber during the COVID-19 pandemic with critical clinical decompensation

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Increased incidence of severe nutritional anaemia in Yorkshire and Humber during the COVID-19 pandemic with critical clinical decompensation
  1. Kate Parmenter1,
  2. Andrew Brookes2,
  3. Sarah Burn3,
  4. Emma Gamwell2,
  5. Peter Jenkins4,
  6. Maria McPhee5,
  7. Sarah Webb6,
  8. Rajeeva Singh7,
  9. Sal Uka5,
  10. Beki James8
  1. 1 Department of Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 Department of Paediatrics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  3. 3 Department of Paediatrics, York District General Hospital, York, UK
  4. 4 Department of Paediatrics, Pinderfields General Hospital, Leeds, UK
  5. 5 Department of Paediatrics, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK
  6. 6 Department of Paediatrics, Bradford Royal Infirmary, Bradford, UK
  7. 7 Department of Paediatrics, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
  8. 8 Regional Centre for Paediatric Haematology and Oncology, Leeds General Infirmary, Leeds, UK
  1. Correspondence to Dr Beki James, Regional Centre for Paediatric Haematology and Oncology, Leeds General Infirmary, Leeds, West Yorkshire, UK; beki.james{at}nhs.net

https://doi.org/10.1136/archdischild-2021-322217

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    Over the last year, the Yorkshire and Humber region has seen an increased incidence of severe nutritional anaemia (NA) presenting with cardiovascular compromise and systemic decompensation. We hypothesise that this is, in part at least, arising as an indirect consequence of the current COVID-19 pandemic.

    We retrospectively analysed data from the seven paediatric departments in our region, identifying all children <16 years of age presenting with severe anaemia (haemoglobin (Hb) <50 g/L) between 1 January 2019 and 31 December 2020. One hundred and eighty-seven cases were identified, including 60 cases of NA (table 1), the vast majority of which were due to iron deficiency. Although the number of severe NA cases diagnosed fell from 34 in 2019 to 26 during the pandemic in 2020, the actual severity of anaemia at presentation was increased (figure 1). There was a significant drop in mean Hb at presentation from 40g/L in 2019 to 33g/L in 2020 (p=0.024), reflecting a doubling of cases with critical anaemia (Hb <30 g/L) in 2020 …

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    Footnotes

    • Contributors BJ, KP and SU initiated the project. AB, SB, EG, BJ, PJ, MM, SW and RS collected data. KP collated the data and coordinated many revisions. EG kept order with minutes from all our meetings. MM provided statistical support. AB, SB, EG, BJ, PJ, MM, SW, RS and SU all contributed to the writing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.