Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown

Abstract

Background We proposed to analyze thoroughly the impact of the COVID-19 lockdown (CL) in changes of profiles and in trend of the domestic accidents (DAs) in children. Methods This was a single experience, cross-sectional study conducted at the emergency department (ED) of III trauma center. We enrolled children under 18 years admitted to ED with a diagnosis of DAs comparing the CL period from 10th March 2020 to 4th May 2020 with the same period of the previous year,10th March 2019 to 4th May 2019. Results In CL period, the cumulative incidence of ED visits for DAs increased from 86.88 to 272.13 per 1,000 children and the cumulative incidence of hospitalizations for DAs increased from 409.72 to 534.48 per 1,000 children. We reported in CL a decrease in the severity of ED presentation assessed by proxy measures: the level of priority ED visits reduced by 67% in CL period (OR: 0.33; 95%CI 0.22–0.48; p < 0.001); the likelihood of delayed time of presentation to ED increased by 65% in case of domestic injuries occurring in CL period (OR: 1.65; 95% CI: 1.17–2.34; p = 0.004); the odds of transfer from other hospital decreased by 78% in CL (OR: 0.15–0.33; p < 0.001). Children were more at risk of poisoning (OR:3.35–106.11; p = 0.001), of body foreign ingestion (OR: 1.83–14.39; p = 0.002) and less at risk of animal bite trauma (OR:0.05–0.35; p < 0.001). Conclusion Although the need to stay home has made a decisive breakthrough on the spread of COVID-19, the experience from this study underlines how this preventive measure has also had a downside in term of increased cumulative incidence of ED visits and of hospitalizations for DA.

Frequency and type of domestic injuries among children during COVID-19 lockdown: what changes from the past? An Italian multicentre cohort study

“…Despite the sharp decrease in the number of ED visits for all causes observed in children during the lockdown period, confirming other Italian literature data [ 7 – 21 ], the number of visits for DAs remained stable, highlighting higher odds of paediatric visits for DA in 2020 than 2019. This increase of risk of DAs during lockdown period confirms data observed in the previous monocentric/regional studies conducted in Italy [ 15 – 17 , 19 , 20 , 22 , 23 ]. It might be explained not only with the growing number of hours spent at home but probably also with the negative psychological effects of COVID-19 home confinement both in children and in parents/caregivers [ 23 ].…”

“…This increase of risk of DAs during lockdown period confirms data observed in the previous monocentric/regional studies conducted in Italy [ 15 – 17 , 19 , 20 , 22 , 23 ]. It might be explained not only with the growing number of hours spent at home but probably also with the negative psychological effects of COVID-19 home confinement both in children and in parents/caregivers [ 23 ]. If lockdown on the one hand concurred to the reduction of total ED visits for the decrease of infectious diseases in children, on the other, it contributed to the deterioration of psychological wellbeing due to home confinement, the lack of personal space, physical activity, and social interaction, not only for children but also in parents.…”

“…If lockdown on the one hand concurred to the reduction of total ED visits for the decrease of infectious diseases in children, on the other, it contributed to the deterioration of psychological wellbeing due to home confinement, the lack of personal space, physical activity, and social interaction, not only for children but also in parents. All these negative effects could bring to a reduction of child supervision with an increase of accidents [ 23 ].…”

“…A recent study has shown that the increase of hospitalization might be explained by change of hospital protocol for injury treatment at ED. If before SARS-CoV-2 pandemic many operative procedures could be performed directly at the ED, during lockdown, patients were hospitalized to receive the same procedures [ 23 ]. However, this change in patient management was not confirmed by all centres participating in this study.…”

Is It Safe to Stay at Home? Parents’ Perceptions of Child Home Injuries during the COVID-19 Lockdown

“…Unfortunately, the special needs of children during disasters and epidemics are often unrecognized [ 7 ]. Lockdown inevitably had serious consequences on the lives and well-being of children and young people, extending beyond those of direct viral infection [ 8 ]. Have we, as a society, seriously considered the effects of the quarantine and prolonged lockdowns, during the recent pandemic, on children’s health, particularly in relation to home injuries?…”