(819) Rates of Naloxone Administration in Pediatric Patient Population Throughout the COVID-19 Pandemic

Introduction: The coinciding COVID-19 pandemic has caused an exacerbation in the opioid epidemic. Currently, there is limited research regarding the effects of the COVID-19 pandemic on the trends of opioid overdoses and naloxone administration in the young pediatric population. With increases in adult opioid use during the pandemic, it is likely that pediatric populations experienced similar exposures, resulting in increased naloxone administrations.

Methods: We conducted a retrospective chart review study of patients under the age of 10 years, who were admitted or transferred to our hospital from 2013 to 2023 and received naloxone. Data included patient demographics, transfer status, place of naloxone administration, total naloxone doses, history of chronic disease and prematurity, need for intubation, type of exposure, and parental employment and marital status. Data comparisons were performed using Kruskal–Wallis tests with significance established at p< 0.05.

Results: A total of 52 patients were included in our study with n=12 (23.1%) in the pre-COVID, n=22 (42.3%) in the early COVID, and n=18 (34.6%) in the late COVID groups. There were n=35 (67.3%) males and n=17 (32.7%) females included. There was no significant difference in the number of doses, total non-infusion/infusion, and total overall dose of naloxone given among groups. Patients in early and late groups had a higher percentage of Medicaid insurance (86.4% and 72.2%, respectively) as compared to the 50% in the pre-pandemic group (p=0.02). Compared to those with non-opioid exposure, a higher percentage of patients with opioid exposure were transfers to our hospital (p=0.04), identified as Black (p=0.04), and required infusions of naloxone (p=0.007). Age on admission was significantly lower for patients with opioid exposure compared to non-opioid exposure (p < 0.001).

Conclusions: Naloxone administration in the young pediatric population has increased during the pandemic, especially during the early period. Patients receiving treatment for opioid overdose were more often males, identified as Black, were hospital transfers, and received infusions of naloxone. Through this research and further exploration of these trends, there is potential to decrease accidental opioid overdose and related injuries in at-risk pediatric patients.