Coronavirus disease 2019 pandemic-related change in children’s visits to the emergency department

Abstract

Purpose: This study was performed to investigate the coronavirus disease 2019 pandemic-related changes in visiting pattern of an emergency department (ED).Methods: The author investigated all children younger than 19 years who visited the ED from 2018 through 2020 without exclusion criteria. Pandemic period was defined as 2020. Variables of interest were monthly and annual numbers of visits, age and age groups (< 1, 1-4, 5-9, 10-14, and 15-18 years), sex, visits for diseases, disposition, high acuity, and top 5 chief complaints per each age group. Timing of social distancing and influenza-related visits were additionally analyzed to speculate the impact of such variables on the visiting patterns.Results: The annual visits were 11,435 (2018), 10,741 (2019), and 5,626 (2020), with a 47.6%-50.8% pandemic-related decrease. Trauma-related visits increased from 27.7%-28.4% to 36.5% (P < 0.001). In the children aged 9 years or younger, trauma as a chief complaint increased from 22.2%-29.6% to 36.2%-42.5% while fever decreased from 27.7%-47.3% to 16.7%-42.6%. In the pre-pandemic period, visits increased in February-March and October-December with a sharp increase in influenza-related visits in the latter 3 months. During the pandemic, a sharp decline in the visits was noted in January-February without the above-mentioned increasing patterns in neither total nor influenza-related visits. After the social distancing was implemented in the 13th week of 2020, the visits remained steady until a slight increase was noted after the school opening.Conclusion: During the pandemic period, a decrease was noted in the numbers of visits to the ED, along with decreases in fever as a chief complaint in young children and influenza-related visits, and the mitigation of social distancing. These findings could be useful in preparing emergency medicine resources for ongoing and future pandemics.

Characteristics of pediatric emergency department visits before and during the COVID-19 pandemic: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022

“…This study provides a nationwide analysis of pediatric ED use in Korea over a span of 5 years, from 2018-2022. Most ED visits were made by boys, with those aged 1-6 years being the most frequent visitors, a trend consistent with previous studies [5,8,11,[13][14][15][16][17]. During the preschool years, children in communal settings like daycare centers or kindergartens are easily exposed to respiratory and gastroenteritis viruses, facilitating the trans-mission of communicable diseases [18][19][20].…”

“…In pediatrics, diseases rather than injuries constitute a major reason for ED visits. This is consistent with previous studies [5,8,11,[13][14][15]17]. As depicted in Table 4, children primarily present to the ED with common symptoms like fever and abdominal pain rather than trauma.…”

“…There are well-documented studies from countries such as the United States, Japan, and Europe that show a significant decrease in pediatric ED visits after the initiation of social distancing measures in March 2020 due to the COVID-19 outbreak [5][6][7][8][9][10]. In Korea, ED visits decreased noticeably across all age groups after the start of the COVID-19 pandemic [11,12], and pediatric ED visits in particular also declined according to data from several hospitals and national data [13][14][15][16]. In other words, these studies show that the number of pediatric patients visiting the ED was influenced by the COVID-19 pandemic in Korea. This study aims to use the National Emergency Department Information System (NEDIS) data to ascertain and analyze the epidemiological patterns of pediatric ED visits from 2018-2022, thereby serving as foundational data for the appropriate allocation of medical resources for pediatric emergency care.…”

Interrupting Effect of Social Distancing on Ischemic Heart Disease, Asthma, Stroke, and Suicide Attempt Patients by PM2.5 Exposure

“…Kang 33 reported a decrease in ED patients during the implementation of SD measures during the global COVID-19 pandemic. Due to the lack of specialists and an increased risk of infection in EDs during the pandemic, specialists met with patients during specific times, and many patients avoided ED visits due to concerns about infection.…”

“…Due to the lack of specialists and an increased risk of infection in EDs during the pandemic, specialists met with patients during specific times, and many patients avoided ED visits due to concerns about infection. 33 34 35 36 The decrease in ED visits could also be attributed to the government’s policy of quarantining people at home to reduce the risk of COVID-19 transmission. In contrast, the number of suicide attempt patients increased post-SD, consistent with previous studies 30 31 that found an association between SD measures and mental health issues.…”