Pediatric emergency department visits during the COVID-19 pandemic: a large retrospective population-based study

Abstract

Background COVID-19 pandemic has stretched healthcare system capacities worldwide and deterred people from seeking medical support at Emergency Departments (ED). Nevertheless, population-based studies examining the consequences on children are lacking. Methods All ED visits from 2019 to 2020 in Veneto, Italy (4.9 million residents) were collected. Anonymized records of pediatric (≤14 years) ED visits included patient characteristics, arrival mode, triage code, clinical presentation, and discharge mode. Year-on-year variation of the main ED visit characteristics, and descriptive trends throughout the study period have been examined. Results Overall, 425,875 ED presentations were collected, 279,481 in 2019, and 146,394 in 2020 (− 48%), with a peak (− 79%) in March–April (first pandemic wave), and a second peak (below − 60%) in November–December (second pandemic wave). Burn or trauma, and fever were the two most common clinical presentations. Visits for nonurgent conditions underwent the strongest reduction during both pandemic waves, while urgent conditions reduced less sharply. ED arrival by ambulance was more common in 2020 (4.5%) than 2019 (3.5%), with a higher proportion of red triage codes (0.5%, and 0.4% respectively), and hospitalizations following ED discharge (9.1%, and 5.9% respectively). Conclusion Since the beginning of the COVID-19 pandemic, pediatric ED presentations underwent a steeper reduction than that observed for adults. Lockdown and fear of contagion in hospital-based services likely deterred parents from seeking medical support for their children. Given COVID-19 could become endemic, it is imperative that public health experts guarantee unhindered access to medical support for urgent, and less urgent health conditions, while minimizing infectious disease risks, to prevent children from suffering direct and indirect consequences of the pandemic.

Suicide spectrum among young people during the COVID-19 pandemic: A systematic review and meta-analysis

“…This result could reflect an increase in suicidal symptomatology but also a reduction in arrivals for several other acute medical conditions, mainly communicable infections and gastrointestinal disorders, 111 , 112 due to both the lower incidence associated with the containment measures during lockdown and the fear of contagion. 113 , 114 According to a report by the Center for Disease Control and Prevention (CDC), this increasing trend in suicidal behaviors might have started in the USA during Summer 2020 and it might have been stable until at least mid-May 2021, corresponding to the end of the study period. 115 Similar temporal trends have been already seen in Australia, UK and Germany.…”

Dental Emergencies in an Italian Pediatric Hospital during the COVID-19 Pandemic

“…A decline in the number of pediatric, adult and senior patients visiting the ER during 2020 and 2021, in particular during COVID-19 waves and NPI periods, together with an increase in hospital admission rates, has been reported in many countries [ 19 , 20 , 21 , 22 ].…”

The year 2021 in COVID-19 pandemic in children

“…The reduction of the access to the first aid and emergency department ranged from 61 to 81% during the first lockdown [ 98 – 101 ]. It correlated with several factors, including a reduced viral exposure due to social distancing measurements and to school-related factors [ 102 – 105 ].…”

“…Of note, the greatest decrease concerned accesses for respiratory disorders likely correlated to the widespread use of personal protective equipment as well as to restrictive measures. The very low rate of flu was suggestive of a possible effect played by personal protective equipment, combined with social distancing [ 98 ]. Moreover, parents and caregivers preferred to stay at home due to fear of contagious, following the national media campaigns.…”