Impact of COVID‐19 epidemics in paediatric morbidity and utilisation of Hospital Paediatric Services in Italy

Manzoni, Paolo; Militello, Maria Angela; Fiorica, Lorenzo; Cappiello, Anna Rita; Manzionna, Mariano

doi:10.1111/apa.15435

Cited by 18 publications

(25 citation statements)

References 1 publication

(1 reference statement)

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“…Indeed, being our hospital qualified as COVID-19 hospital, our ED was efficiently reorganized to avoid intrahospital spread of SARS-CoV-2, separating suspected COVID-19 and standard care pathways. We detected only 1 case positive to SARS-CoV-2 (a 1.9-year-old girl admitted for complex febrile seizure) among 68 symptomatic and 47 asymptomatic patients tested with nasopharyngeal swab, confirming the low prevalence of COVID-19 among children and adolescents reported by other Italian records [7,8,17,27]. Febrile seizures represent a rare presentation of COVID-19 in pediatric age.…”

Section: Discussionsupporting

confidence: 81%

“…A significant reduction in pediatric ED consultations (ranging from 73 to 84%) during COVID-19 pandemic has been reported also by few other Italian hospitals of Northern , showing a 76.3% decrease [20], a finding similar to our results. Furthermore, Italian studies reported that pediatric patients had more appropriate accesses to ED during COVID-19 pandemic [16,17,20]. Thus, available data suggest that even if COVID-19 outbreak more seriously affected Northern Italy, utilization of pediatric emergency services significantly changed in the entire country with consequent reduced demand and increased appropriateness.…”

Section: Discussionmentioning

confidence: 99%

“…Monthly comparison of pediatric ED visits performed from January to May 2020 confirmed a significant reduction in daily consultations after February, with a considerable percentage of days with ≤ 3 visits/day ( Table 1). Daily pediatric ED consultations significantly varied also considering pre-and post-lockdown beginning period (pre-lockdown, 16 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)…”

Section: Impact Of Covid-19 Pandemic On Pediatric Ed Consultationsmentioning

confidence: 99%

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How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Vierucci¹,

Bacci

Mucaria

et al. 2020

SN Compr. Clin. Med.

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Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), p < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March − 74.6%, April − 71.6%, May − 58.6%). Nasopharyngeal What is Known: Italy was the first European country hit by SARS-CoV-2 infection. Published preliminary Italian data confirmed a general favorable clinical course of COVID-19 in childhood. What is New: Even if COVID-19 pandemic more seriously affected Northern Italy, the admission of children and adolescents to pediatric emergency services significantly changed also in Central Italy with reduced demand and increased appropriateness.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Impact Of Covid-19 Pandemic On Pediatric Ed Consultationsmentioning

confidence: 99%

See 1 more Smart Citation

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Vierucci¹,

Bacci

Mucaria

et al. 2020

SN Compr. Clin. Med.

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“…Eight were from China, 45,50,68,70,72-74,77 7 from other low and middle-income countries (LMIC; Turkey, 58,79 Pakistan, 25 India, 28,65 Brazil, 55 Bangladesh 76 ) and 13 from Italy, 23,26,27,32,35,38,49,56,78,81,84-86 21 from the UK, 22,29-31,37,39-42,44,47,48,54,60,62-64,69,87,89,90 12 from the USA, 24,43,46,51,57,59,66,67,71,75,92,94 and 1 study each from Ireland, 88 France, 91 Germany, 93 Greece, 80 Spain, 61 Finland, 34 Slovenia, 33 Israel, 82,83 Australia, 52 Canada 53 and Japan. 36…”

Section: Resultsmentioning

confidence: 99%

Impacts of school closures on physical and mental health of children and young people: a systematic review

Viner

Russell

Saulle

et al. 2021

Preprint

102

101

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Background The well-documented links between education and health mean that school closures during the COVID-19 pandemic are likely to be associated with significant health harms to children and young people (CYP). A systematic review of the evidence is needed to inform policy decisions around school closures and re-openings during the pandemic. Methods We undertook a high-quality systematic review of observational quantitative studies (published or preprint) of the impacts of school closures (for any reason) on the health, wellbeing and educational outcomes of CYP, excluding impacts of closure on transmission of infection (PROSPERO CRD42020181658). We used a machine learning approach for screening articles, with decisions on inclusion and data extraction performed independently by 2 researchers. Quality was assessed for study type. A narrative synthesis of results was undertaken as data did not allow meta-analysis. Results 16,817 records were screened, of which 151 were reviewed in full-text and 72 studies were included from 20 countries. 33% were cohort studies using historical control periods; 19% pre-post studies; and 46% cross-sectional studies which assessed change by comparison with population reference data. 63% were high-quality, 25% medium-quality and 13% low-quality. Cause of closure in all studies was the first COVID-19 pandemic wave with the exception of 5 influenza studies and 1 teacher strike. 27 studies concerning mental health identified considerable impacts across emotional, behavioural and restlessness/inattention problems; 18-60% of CYP scored above risk thresholds for distress, particularly anxiety and depressive symptoms. Two studies reported non-significant rises in suicide rates. Self-harm and psychiatric attendances were markedly reduced, indicating a rise in unmet mental health need. Child protection referrals fell 27-39%, with a halving of the expected number of referrals originating in schools. 19 studies concerning health service use showed marked reductions in emergency department (ED) presentations and hospital admissions, with evidence of delayed presentations and potential widening of inequalities in vaccination coverage. Data suggested marked rises in screen-time and social media use and reductions in physical activity however data on sleep and diet were inconclusive. Available data suggested likely higher harms in CYP from more deprived populations. Conclusions School closures as part of broader social distancing measures are associated with considerable harms to CYP health and wellbeing. Available data are short-term and longer-term harms are likely to be magnified by further school closures. Data are urgently needed on longer-term impacts using strong research designs, particularly amongst vulnerable groups. These findings are important for policy-makers seeking to balance the risks of transmission through school-aged children with the harms of closing schools.

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“…A notable drop in pediatric admissions for acute lower respiratory tract infections (LRTI) other than COVID-19, particularly viral LRTI, has been described in a number of countries (26)(27)(28). In the Southern Hemisphere, the COVID-19 pandemic coincided with the annual 2020 viral respiratory season.…”

Section: Covid-19: Impact On Acute Lower Respiratory Tract Infectionsmentioning

confidence: 99%

COVID-19 and Pediatric Lung Disease: A South African Tertiary Center Experience

et al. 2021

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The COVID-19 pandemic led to rapid global spread with far-reaching impacts on health-care systems. Whilst pediatric data consistently shown a milder disease course, chronic lung disease has been identified as a risk factor for hospitalization and severe disease. In Africa, comprised predominantly of low middle-income countries (LMIC), the additional burden of HIV, tuberculosis, malnutrition and overcrowding is high and further impacts health risk. This paper reviewed the literature on COVID-19 and chronic lung disease in children and provides our experience from an African pediatric pulmonary center in Cape Town, South Africa. South African epidemiological data confirms a low burden of severe disease with children <18 years comprising 8% of all diagnosed cases and 3% of all COVID-19 admissions. A decrease in hospital admission for other viral lower respiratory tract infections was found. While the pulmonology service manages children with a wide range of chronic respiratory conditions including bronchiectasis, cystic fibrosis, asthma, interstitial lung disease and children with tracheostomies, no significant increase in COVID-19 admissions were noted and in those who developed COVID-19, the disease course was not severe. Current evidence suggests that pre-existing respiratory disease in children does not appear to be a significant risk factor for severe COVID-19. Longitudinal data are still needed to assess risk in children with immunosuppression and interstitial lung diseases. The indirect impacts of the pandemic response on child respiratory health are notable and still likely to be fully realized and quantified. Ensuring children have access to full preventive and care services during this time is priority.

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Impact of COVID‐19 epidemics in paediatric morbidity and utilisation of Hospital Paediatric Services in Italy

Cited by 18 publications

References 1 publication

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Impacts of school closures on physical and mental health of children and young people: a systematic review

COVID-19 and Pediatric Lung Disease: A South African Tertiary Center Experience

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