Impact of the COVID-19 pandemic in the paediatric emergency department attendances in Argentina

Ferrero, Fernando; Ossorio, María Fabiana; Torres, Fernando; Debaisi, Gustavo

doi:10.1136/archdischild-2020-319833

Cited by 37 publications

(34 citation statements)

References 2 publications

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“…Our data was consistent with a study done in Italy where the number of domestic accidents presenting to Paediatric Emergency Department increased significantly during COVID‐19 lockdown compared to previous year 7 . But other studies in Manchester, UK, and Argentina showed a decrease in up to 30%–88% of paediatric emergency attendees during COVID‐19, 8,9 though this did not only focus on domestic accidents, their studies reflect on the question: where have the children gone? They conclude that children requiring medical attention may not have sought it, and that the health system support network has not helped them in the difficult circumstances of compulsory social distancing.…”

Section: Discussionsupporting

confidence: 91%

Paediatric domestic accidents during COVID‐19 pandemic in Hong Kong

2020

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Background With school closures and social isolation imposed by the COVID‐19 pandemic, both children and parents in Hong Kong have been forced to stay at home for extended periods of time. Besides the disease itself growing globally, this pandemic has inflicted many other healthcare problems. This study aims to look at the impact of COVID‐19 pandemic on paediatric surgical accidents. Methods A retrospective review of all patients under 18 years of age admitted to a tertiary paediatric surgical unit with accidents was done between January to May 2020 (COVID‐19 social isolation period). Comparison was made with cases between January to May 2018 and 2019. Inclusion diagnoses include foreign body ingestion (FBI), scald injury, animal bite, and fall. Demographic data including age and gender, details of injury and treatment, and length of hospitalization were recorded. Statistical analysis was performed by Fisher exact test and statistical significance was defined as P ≤ .05. Results A total of 35 patients were admitted during the period 1‐5/2020 compared to 28 patients in 1‐5/2019 and 16 patients in 1‐5/2018. Median age at presentation is 3 years. Diagnoses include FBI, animal bite, scald injury and fall. Thirteen required surgical intervention including oesophagogastroduodenoscopy (20%), wound debridement (13%), wound suturing (67%). Mean length of hospital stay was 2.89 days. The proportion of domestic accidents in 2020 increased compared with the same period in 2018 and 2019 (P‐values = .0001, .0259). Non‐food foreign body ingestions at home during COVID19 increased significantly (P‐values = .0018, .0223). Surgical intervention required for domestic accidents in 2020 also increased (P‐values = .1223, .107). Conclusion The social isolation imposed by the COVID‐19 pandemic has caused an increase in paediatric domestic accidents requiring admission to our surgical ward. Governments and healthcare authorities should proactively implement appropriate intervention programs and better plan resources to prevent these domestic accidents during lockdown.

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Section: Discussionsupporting

confidence: 91%

Paediatric domestic accidents during COVID‐19 pandemic in Hong Kong

2020

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“…There was a corresponding increase in the proportion of traumarelated cases. The sharp decline in the overall number of cases seen during the pandemic is consistent with other published reports, which have attributed this phenomena to social 95%CI 95% confidence interval distancing measures that reduced the rate of transmission of infections, as well as public fear of visiting healthcare institutions [28][29][30]. In our institution, this decline in attendance has not been seen in previous years and cannot be attributed to seasonal changes in ED attendances.…”

Section: Discussionsupporting

confidence: 90%

Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore

et al. 2020

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Background Coronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore. Methods We performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs). Results We attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change − 87.9, 95% CI − 89.3 to − 86.3, p < 0.001) and gastrointestinal infections (% change − 72.4, 95%CI − 75.9 to − 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change − 40.0, 95%CI − 44.3 to − 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change − 73.9, 95%CI − 75.9 to − 71.7, p < 0.001). Conclusions We highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.

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“…Reduced access to healthcare facilities in fear of nosocomial transmission may also cause reduced routine hospital visits, thereby reducing the number of routine examinations. 12 17 A previous study suggested greater consequences for pediatric patients due to the fear of COVID-19 that results in delayed access to care, and called for “high-quality coordinated care.” 10 18 …”

Section: Discussionmentioning

confidence: 99%