Changing Admission Patterns in Pediatric Emergency Departments during the COVID-19 Pandemic in Italy Were Due to Reductions in Inappropriate Accesses

Abstract

During the initial phase of the national lockdown, we found that there were sharp decreases in admissions to two pediatric emergency departments (EDs) in northern Italy (Cremona and Novara). Here we present a detailed analysis of these admission patterns and types of admissions over a longer timeframe. ED admissions data were anonymously extracted from the departmental management software. Admissions data from 2019 and 2020 were analyzed and compared separately for each ED and combined. There was a 73.2% decrease in total admissions compared with the same period in 2019. With respect to admission diagnoses, there was a significant (p < 0.001) drop in infectious (−51%), respiratory (−25.5%), and nervous systems diseases (−50%) and injuries and poisoning (−17%) but not endocrine, metabolic, neoplastic, circulatory, or musculoskeletal diseases. White codes (patients with minor injuries for whom ED medical care is not required) significantly decreased by 56.3% (p < 0.001). Even if the COVID-19 pandemic represented an enormous healthcare burden in Italy, especially during the first months of the pandemic (late February to May), the workload of pediatric EDs was significantly reduced, especially for unnecessary accesses (white codes).

Pediatric Emergency Department Management in Acute Poisoning—A 2-Year Retrospective Study

“…Regarding the seasonal variations, we identified a lower incidence of cases in spring of 2020 compared to 2019 (20.86% versus 27.96%), which could be explained by the state of emergency imposed by the SARS-CoV-2 pandemic that limited travel and led to closer surveillance of pediatric patients. These percentages were similar to those identified in other studies regarding the number of admissions for poisoning in pediatric ED during the SARS-CoV-2 pandemic [ 1 ].…”

Reduced burden of antibiotic prescription in an italian pediatric primary care clinic during the first wave of COVID-19 pandemic: a shot in the arm for antimicrobial resistance?

“…We evaluated the antibiotic prescription rate according to the diagnosis at discharge. The total number of visits significantly decreased (1335 in 2020 vs. 4899 in 2019), as previously reported [ 7 ]. Although the rate of antibiotic prescriptions at discharge only slightly decreased (1039 in 2019, 21.2%, vs. 272 in 2020, 20.4%), numerically, antibiotic prescriptions decreased by 73.8%, with antibiotic prescriptions for RTIs accounting for 69% of the total reduction.…”

Life Satisfaction and Perceived Stress versus Health Promoting Behavior among Medical Students during the COVID-19 Pandemic

“…Preventive behaviors during this particular period could be associated with increased stress for various reasons. During the pandemic, access to health care was significantly limited; therefore, it became difficult to conduct any preventive examinations during this period [ 46 , 47 , 48 , 49 ]. On the other hand, constant reminding and emphasizing the need to maintain social distance, wearing masks, and frequent hand washing could generate stress by the very fact of the enormous importance that these behaviors acquired during this time [ 50 , 51 ].…”