Using the Emergency Care Data Set for the epidemiological surveillance of Children and Young People aged less than 18 years: a case study of COVID-19 in England 2020-2023

Background The Emergency Care Data Set provides insight into emergency care activity in England, and combined with COVID-19 surveillance data, can provide new insights into acute COVID-19 infection.

This study identified individuals <18 years old who tested positive for SARS-CoV-2 between February 2020 and March 2023 and attended emergency care 1-14 days after a positive test. The study’s main objective was to explore ED attendance outcomes by demographic characteristics.

There were significant differences (p < 0.05) across most of the characteristics of <18s admitted to hospital from emergency departments, and those who were discharged from ED. <18s in IMD decile 1 (14.9%) made up the highest proportion of admissions, with those in less deprived areas having a greater proportion of individuals discharged from ED. February to August 2020 (1.5%) and September 2022 to March 2023 (2.8%) saw the highest proportion of <18 cases attending ED, though the highest number of cases were seen between September 2021 and February 2022.

There is great value in the use of ECDS. It facilitates quick, regular insights into the health outcomes of key demographics, and provides a window into the health-seeking behaviours of individuals. Furthermore, outcomes of emergency care attendance can potentially inform assessments of infection severity across multiple demographics during outbreaks and pandemics. Competing Interest Statement The authors have declared no competing interest. Funding Statement The study did not receive any specific grant from funding agencies. The study was supported by the UK Health Security Agency. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: UKHSA has legal permission, provided by Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002 to process confidential patient information under Sections 3(i) (a) to (c), 3(i)(d) (i) and (ii) and 3(iii) as part of its outbreak response activities. This study falls within the research activities approved by the UKHSA Research Ethics and Governance Group. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes