The impact of COVID-19 on paediatric emergency department visits. A one-year retrospective study

Kostopoulou, Eirini; Gkentzi, Despoina; Papasotiriou, Marios; Fouzas, Sotirios; Tagalaki, Anastasia; Varvarigou, Anastasia; Dimitriou, Gabriel

doi:10.1038/s41390-021-01815-w

Cited by 29 publications

(39 citation statements)

References 17 publications

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“…Several studies recorded longer prehospital delay in admission of acute appendicitis during the pandemic [ 9 , 31 , 35 , 37 , 38 , 41 ], while other studies showed no significant difference between pandemic and pre-pandemic delay of presentation [ 31 , 34 , 36 , 38 , 40 , 42 ]. Significant increases in delayed care for different medical emergencies, including pediatric surgical emergencies, during the COVID-19 pandemic period have been noted by the medical community and published in several reports [ 65 ]. The effects of the COVID-19 pandemic are recorded in other urgent pediatric surgery conditions such as testicular torsion, in which latest studies show significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a significantly higher proportion of patients reported delaying care [ 17 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Complicated Appendicitis during the COVID-19 Pandemic versus the Pre-Pandemic Period: A Systematic Review and Meta-Analysis of 2782 Pediatric Appendectomies

et al. 2022

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Background: The Coronavirus Disease 2019 (COVID-19) pandemic has impacted volume, management strategies and patient outcomes of acute appendicitis. The aim of this systematic review and meta-analysis was to evaluate whether the COVID-19 pandemic resulted in higher incidence of complicated appendicitis in children presenting with acute appendicitis compared to the pre-COVID-19 period. The secondary aim was to investigate the proportion of the patients treated by non-operative management (NOM). Methods: A systematic search of four scientific databases was performed. The search terms used were (coronavirus OR SARS-CoV-2 OR COVID-19 OR novel coronavirus) AND (appendicitis). The inclusion criteria were all patients aged <18 years and diagnosed with acute appendicitis during the COVID-19 and pre-COVID-19 periods. The proportion of children presenting with complicated appendicitis and the proportion of children managed by NOM was compared between the two groups. The Downs and Black scale was used for methodological quality assessment. Results: The present meta-analysis included thirteen studies (twelve retrospective studies and one cross-sectional study). A total of 2782 patients (1239 during the COVID-19 period) were included. A significantly higher incidence of complicated appendicitis (RR = 1.63, 95% CI 1.33–2.01, p < 0.00001) and a significantly higher proportion of children managed via the NOM (RR = 1.95, 95% CI 1.45–2.61, p < 0.00001) was observed in patients during the COVID-19 pandemic when compared to the pre-COVID-19 period. Conclusion: There is a significantly higher incidence of complicated appendicitis in children during the COVID-19 pandemic than in the pre-COVID-19 period. Additionally, a significantly higher proportion of children was managed via the NOM during the pandemic in comparison to the pre-pandemic period.

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Section: Discussionmentioning

confidence: 99%

Incidence of Complicated Appendicitis during the COVID-19 Pandemic versus the Pre-Pandemic Period: A Systematic Review and Meta-Analysis of 2782 Pediatric Appendectomies

et al. 2022

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“…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 ].…”

Section: Discussionmentioning

confidence: 99%

“…The novel coronavirus SARS-CoV-2 was identified as the causative agent for a fastspreading series of atypical respiratory symptoms in the Hubei Province of Wuhan, China in December of 2019. The resulting disease, named coronavirus disease 2019 (COVID- 19) quickly spread to the rest of the world. Between February and April 2020, Italy experienced one of the largest clusters and case-fatality rates of COVID-19 worldwide.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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Emergency rooms (ER) are largely used by patients with oral complaints, who choose the ER over private or public dental offices for oral prevention and treatment. During the COVID-19 pandemic, the activity of most dental facilities was limited, and most hospitals and ERs were dedicated to the treatment of COVID-19 patients. The present study analyzed the number of and reason for visits at the emergency room (ER) of Ospedale dei Bambini “Vittore Buzzi”, the main pediatric hospital in Milano, Italy, between 2019 and 2020, with a particular focus on oral emergencies. In 2019, 25,435 children turned to the ER, compared to 16,750 in 2020. About 10% of the children were eventually admitted to the hospital in both years. The number of admissions for infectious diseases, other than COVID-19, signed an important decrease in 2020, while trauma/injuries decreased slightly in number but increased in proportion. The number and proportion of ER visits for oral complaints decreased in 2020 compared to 2019. Stomatitis was the most frequent condition, followed by traumatic injuries, which decreased in number and percentage between 2019 and 2020. Oral infections and painful caries accounted for about 15% of the cases in both 2019 and 2020. These data highlight the need to promote territorial services for the prevention and treatment of oral health complaints, including dental emergencies.

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“…Honeyford et al provided a conceptual framework to explain the changes in ED attendance, which includes fear as well as changes in access to other parts of the health care system, increased hand hygiene, and decreased physical activity [ 21 ]. Kostopoulou et al also provided possible explanations for the decline of pediatric ED visit during the pandemic, which included (1) restriction of infection transmission, (2) avoidance of unnecessary ED visits, and (3) fear of exposure to COVID-19 [ 22 ]. In our study, we found a significant decline in AGE cases (approximate 40%) after the pandemic, even in the slack periods, which was more prominent than ED visits for constipation.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 by Pandemic Wave among Patients with Gastroenterology Symptoms in the Emergency Departments at a Medical Center in Taiwan

Kuo

Liu

Chien

et al. 2022

IJERPH

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The COVID-19 pandemic has affected emergency department (ED) usage. This study examines changes in the number of ED visits for gastrointestinal (GI) bleeding and nonemergency GI conditions, such as acute gastroenteritis (AGE) and constipation, before the pandemic and at the peak and slack periods of the pandemic in Taiwan. This retrospective observational study was conducted at a referral medical center in northern Taiwan. We recorded the number of weekly ED visits for GI bleeding, AGE, and constipation from 2019 to 2021. We then compared the baseline period (calendar weeks 4–18 and 21–31, 2019) with two peak pandemic periods (period 1, calendar weeks 4–18, 2020; period 2, calendar weeks 21–31, 2021) and their corresponding slack periods. The decline in the number of ED visits during the two peak pandemic periods for GI bleeding (−18.4% and −30.2%) were not as substantial as for AGE (−64.1% and −76.7%) or for constipation (−44.4% and −63.6%), but GI bleeding cases were still significantly lower in number relative to the baseline. During the slack period, the number of ED visits for all three diagnoses rebounded but did not exceed the baseline. Our study revealed that there was a significant decline of GI complaint during the pandemic. This phenomenon was more prominent in nonemergency complaints (AGE and constipation) and less prominent in serious complaints (GI bleeding).

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The impact of COVID-19 on paediatric emergency department visits. A one-year retrospective study

Cited by 29 publications

References 17 publications

Incidence of Complicated Appendicitis during the COVID-19 Pandemic versus the Pre-Pandemic Period: A Systematic Review and Meta-Analysis of 2782 Pediatric Appendectomies

Incidence of Complicated Appendicitis during the COVID-19 Pandemic versus the Pre-Pandemic Period: A Systematic Review and Meta-Analysis of 2782 Pediatric Appendectomies

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

Impact of COVID-19 by Pandemic Wave among Patients with Gastroenterology Symptoms in the Emergency Departments at a Medical Center in Taiwan

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