Telemedicine and Utilization of Chest X-Rays in Pediatric Community-Acquired
Pneumonia: Lessons from the COVID-19 Lockdown
#MMPMID41341809
Eilat-Tsanani S
; Almog M
; Levy V
Telemed Rep
2025[]; 6
(1
): 396-400
PMID41341809
show ga
Community-acquired pneumonia (CAP) is a leading infectious disease in children,
with management guidelines emphasizing clinical judgment over routine imaging.
The COVID-19 pandemic accelerated telehealth adoption, raising questions about
its impact on pediatric CAP care. We conducted a retrospective database study
within primary care, comparing chest X-ray use for CAP diagnosis during three
lockdown periods (2020-2021) with corresponding pre-pandemic periods (2018-2019).
Children aged 1-14 years with CAP diagnoses were included (n = 3,499
pre-pandemic; n = 438 during lockdown). Remote consultations increased
significantly (1.7% vs. 11.6%, p < 0.001), while chest X-ray referrals remained
stable, and antibiotic use also stayed consistent. Predictors for imaging
shifted: pre-pandemic, older age and longer travel distance were significant
factors, whereas during lockdown, only higher socioeconomic status was
associated. The ongoing use of telemedicine after COVID-19 offers an opportunity
to develop strategies that improve diagnostic confidence and encourage "choosing
wisely" in pediatric pneumonia diagnosis.