Impact of the COVID-19 Outbreak on Trends in Emergency Department Utilization in Children: a Multicenter Retrospective Observational Study in Seoul Metropolitan Area, Korea

Abstract

Background Understanding the changes in emergency department (ED) visit patterns during the coronavirus disease 2019 (COVID-19) outbreak is important for effectively operating EDs during the pandemic. We aimed to analyze the changes in pediatric ED visits during the COVID-19 pandemic and examine the relationship between the number of ED visits and the stringency of government social distancing measures. Methods This multicenter retrospective study used data of pediatric (age < 18 years) ED visits in Seoul metropolitan area from June 1, 2018, to May 31, 2020. Patient demographics, ED results, and diagnoses were compared during the COVID-19 period and the previous year. To evaluate the effect of the stringency of social distancing measures on the number of ED visits, a Poisson regression model was developed with month, year, and the average monthly Government Response Stringency Index (GRSI) as fixed effects. Results In total, 190,732 patients were included. The number of pediatric ED visits during the COVID-19 period was 58.1% lower than in the previous year. There were disproportionate decreases in the numbers of ED visits for children in early childhood (66.5%), low-acuity children (55.2-63.8%), those who did not use an ambulance (59.0%), and those visiting the ED for noninjury complaints (64.9%). The proportion of admissions increased from 11.9% to 16.6%. For every 10-point increase in the GRSI, there was a 15.1% decrease in monthly ED visits. Conclusion A striking decrease in pediatric ED visits was observed during the COVID-19 outbreak, the scale which was associated with the stringency of government policies. Changes in the number and characteristics of children visiting the ED should be considered to facilitate the effective operation of EDs during the pandemic.

Changes in the Occurrence of Gastrointestinal Infections after COVID-19 in Korea

“…In addition, the incidence of influenza virus, respiratory syncytial virus, and mycoplasma infections, which are prevalent in every winter, also decreased in 2020. 4 5 6 …”

Decreased door-to-balloon time in patients with ST-segment elevation myocardial infarction during the early COVID-19 pandemic in South Korea – an observational study

“…21-23 Therefore, the reduction of the door-to-balloon time could be attributed to decreased emergency care utilisation during the early COVID-19 pandemic as patients with low severity defer emergency department visits owing to the fear of the infection in the medical facility. 22 23 This decrease in emergency care utilisation was also observed during the MERS outbreak in 2015 in South Korea. 24…”

“…Previous Korean studies reported decreased number of patient-visit to emergency department (46%-77%) during the early COVID-19 pandemic. [21][22][23] Therefore, the reduction of the door-to-balloon time could be attributed to decreased . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Effect of coronavirus disease 2019 on febrile children’s visits to the emergency department of a tertiary hospital

“…This study shows that the number of overall visits to the ED of a Korean tertiary hospital sharply decreased during the COVID-19 pandemic. This decrease has been experienced in many countries according to the studies during the pandemic 11,12) . Despite the decrease in overall visits, higher severity and hospitalization rates were shown in an analysis of all children who visited a U.S. ED over a 10-week period at the beginning of the pandemic 13) .…”