Neonatal and Pediatric Emergency Room Visits in a Tertiary Center during the COVID-19 Pandemic in Italy

Abstract

The COVID-19 pandemic is affecting healthcare services worldwide. We investigated the impact of a strict lockdown policy on the characteristics of neonatal and pediatric attendances to our pediatric emergency department (PED). The clinical features of PED visits in March–April 2020 (COVID-19) and March–April 2019 (non-COVID-19) were analyzed. During the COVID-19 lockdown period, visits reduced by 67%, from 3159 to 1039. Neonatal access decreased from 78 to 59, mainly due to fewer pathological conditions, with a complete disappearance of respiratory infections. On the other hand, minor neonatal clinical conditions rose from 44 (56.4%) to 48 (81.4%), mostly due to feeding-related issues. Communicable diseases, particularly respiratory infections and gastroenteritis, dropped from 1552 (49.1%) to 288 (27.7%). Accident-related visits also decreased during COVID-19, from 535 (16.9%) to 309 (29.7%), becoming the most common cause of PED access. Hospital admissions reduced from 266 to 109, while PICU (pediatric intensive care unit) admissions decreased from 27 to 11, with a comparable rate of 10.1% in both periods. The lockdown due to COVID-19 had a substantial impact on our PED visits, which markedly decreased, mainly due to fewer respiratory infections. Unexpectedly, neonatal visits for minor conditions did not decline, but rather slightly increased. Among the children admitted to the PICU, none had respiratory disease.

Pediatric emergency department visits due to child abuse and neglect following COVID-19 public health emergency declaration in the Southeastern United States

“…However, the proportion of CAN-related ED visits significantly increased during the pandemic [ 21 , 22 ]. Similar findings have emerged in other countries, such as England [ 23 , 24 ], Singapore [ 25 ] and Italy [ 26 ].…”

“…This study is limited to one hospital system in the southeastern United States. Given the consistencies of the declines in overall pediatric ED use and CAN-related ED use to studies using data from multiple hospital systems [ 20 – 22 , 25 , 26 ], however, we expect our results are likely representative of large, urban hospital systems and their patient populations.…”

Effects of Relaxed Lockdown on Pediatric ER Visits during SARS-CoV-2 Pandemic in Italy

“…Our results were superimposable on other studies that reported reductions in injuries in pediatric age in UK, Germany, Belgium, France, Italy, USA, South Africa and Singapore [ 13 , 17 , 33 , 34 , 35 , 36 , 37 ]. Along this hypothesis, several studies demonstrated a drastic drop in pediatric ER visits for accidents during the lockdown period [ 6 , 38 , 39 ]. This decreasing trend is confirmed also by more recent published works that analyzed different timeframes, in particular until June [ 40 ] and August [ 41 ] 2020, when strict lockdown measures were patchily reintroduced.…”

Epidemiology of pediatric trauma during the coronavirus disease-2019 pandemic

“…Overall pediatric emergency department (ED) visits declined significantly as the pandemic evolved. [1] , [2] , [3] Similarly, overall visits for injuries also declined[ 1 , 4 , 5 ] and single center reports describe similar declines in pediatric trauma volumes during the pandemic. [6] , [7] , [8] , [9] The late 2020 surge in LA County significantly altered referral patterns and emergency medical services mandates for both medical and trauma patients within LA County due to the overwhelming effect of COVID-19 on the pre-hospital and hospital systems.…”