Aims/Objectives/Background There have been anecdotal reports that delay in presenting to Children’s Emergency Departments (CED) during COVID19, combined with a reduction in more minor cases, has increased the relative acuity of children in CED.

Methods/Design In order to determine the impact of SARS-CoV-2 on our tertiary CED we compared attendances, diagnosis at discharge, initial paediatric observation priority score (POPS) and Healthcare Resource Group (HRG) code for the months of March, April and May 2018, 2019 and 2020. POPS is a bespoke early warning-like score and is calculated between 0–16 (0 low acuity;16 high acuity) based on 8 components including vital signs and subjective observations. A large proportion of children presenting have an unrecorded or POPS 0 as they are an injury so a POPS of greater than 0 was used in analysis. A lower HRG scores indicates increased resource utilisation.

Results/Conclusions Presentations in March, April and May 2020 fell compared with previous years with overall HRG weighting slightly increasing to 8.71 from 8.48 (2019) and 8.98 (2018) which is a clinically negligible change. There was a trend for a greater proportion of children with a POPS 0 in 2020 compared to previous years. Mean and median POPS was unchanged (table 1). Children diagnosed with an infectious disease fell by 30.5 attendances per 1000 presentations and soft tissue injuries fell by 10.0 attendances per 1000 presentations comparing 2020 and 2019. There were increases in codes relevant to specific paediatric diagnoses (croup, febrile convulsion etc.) by 11.4 attendances per 1000 presentations in the same time period and fracture/dislocations increased by 9.1 attendances per 1000 presentations.

While having a huge impact on childrens’ presentations to Emergency Departments there is no evidence, in our institution, of significantly elevated acuity, or a large change in case-mix, as a result of the COVID19 pandemic compared to previous years.