The impact of COVID-19 lockdown on infectious diseases epidemiology: The experience of a tertiary Italian Pediatric Emergency Department

Abstract

The aim of this study was to describe the rate and types of community-acquired respiratory infections observed in a pediatric ED during the SARS-CoV-2 related lockdown in Italy and to compare data with the same period of previous year. Methods: A retrospective analysis of medical charts of patients arrived at the ED of Gaslini Children's Hospital from 10th March 2020 to 30th April 2019 and the same frame of 2020 were performed. We compared two groups by demographics, duration of fever before ED admission, triage code, number of patients hospitalized after ED evaluation. We calculated proportion and incidence rate for airborne infections, fever, and urinary tract infections (UTI), appendicitis, and gastroenteritis for control. Results: 1362 children arrived at the ED during the lockdown compared to 5628 in the same period of 2019 (−75,8%). No difference was noticed (27.7% vs 28.4%) in the total amount of infectious episodes. A significant reduction in rate of incidence and proportion were observed for upper respiratory tract infections (21,4% vs 28%), otitis (2,6% vs 16,2%), streptococcal infections (0,5% vs 5,2%) and bronchiolitis (2,1% vs 5,7%). Conversely, FUO (27,8 vs 11,1%), infectious mononucleosis (2,6% vs 0,4%), UTI (7,4% vs 2,9%) and appendicitis (6,8% vs 1,1%) significantly increased. Median time from the onset of fever and arrival in ED was significantly lower in 2020 group. Conclusion:Our results demonstrated a reduction in community-acquired respiratory infections during the lockdown for COVID-19. The increase in rate of FUO and febrile conditions, together with the short time from fever onset and ED visit could be related to the fear for a SARS-CoV-2 infection.

Impact of the COVID-19 Lockdown on Ophthalmological Assistance in the Emergency Department at a Spanish Primary Level Hospital

“…The observed reduction probably reflects the real incidence of this infection because the few cases of these complications (PM and CSEI) were seen during the harder days of the lockdown (March and April). Other authors have demonstrated a similar trend in child infections at the emergency department [ 24 ].…”

COVID-19 Pandemic Impact on Respiratory Infectious Diseases in Primary Care Practice in Children

“…Outside the U.S., studies conducted during the first months during lockdown involving pediatric emergency departments in France, Italy, and New Zealand showed significant reductions in emergency visits of children with respiratory disease in a wide age range (28). A reduction in AOM episodes during lockdown was reported from the U.S., Italy, and France from general pediatric (26,29) and emergency room settings (28,30,31). A high rate of improvement in children with chronic otitis media with effusion (OME) was also reported during lockdown (29,32).…”

Surveillance for Enteroviruses Associated with Hand, Foot, and Mouth Disease, and Other Mucocutaneous Symptoms in Spain, 2006–2020

“…The number of EV-positive samples associated with HFMD/exanthema received in the lab increased over the years of the study period, until March 2020 where they dropped sharply due to the COVID-19 pandemic, as has occurred with other transmissible diseases [ 38 ]. The explanation could be in increased circulation of CVA6 with a more visible clinic manifestations and also greater interest of clinicians in EV surveillance, as has occurred in other European countries in recent years [ 22 , 36 ].…”