The impact of the COVID‐19 lockdown in Italy on a paediatric emergency setting

Cozzi, Giorgio; Zanchi, Chiara; Giangreco, Manuela; Rabach, Ingrid; Calligaris, Lorenzo; Giorgi, Renata; Conte, Mariasole; Moressa, Valentina; Delise, A.; Poropat, Federico

doi:10.1111/apa.15454

Cited by 51 publications

(71 citation statements)

References 2 publications

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“…A significant reduction in pediatric ED consultations (ranging from 73 to 84%) during COVID-19 pandemic has been reported also by few other Italian hospitals of Northern , showing a 76.3% decrease [20], a finding similar to our results. Furthermore, Italian studies reported that pediatric patients had more appropriate accesses to ED during COVID-19 pandemic [16,17,20]. Thus, available data suggest that even if COVID-19 outbreak more seriously affected Northern Italy, utilization of pediatric emergency services significantly changed in the entire country with consequent reduced demand and increased appropriateness.…”

Section: Discussionsupporting

confidence: 92%

“…In addition, parental fear of contracting SARS-CoV-2 infection in hospital settings represented a significant determinant of ED accesses reduction. Late diagnoses, sometimes with consequent death due to delayed access to hospital care, have been reported in March 2020 in some [15,19] but not all [20] Italian secondary and tertiary care hospitals. In our study, we described 2 cases of delayed ED access to hospital setting (1 in April and 1 in May), as a consequence of not justified parental fear.…”

Section: Discussionmentioning

confidence: 99%

“…Monthly comparison of pediatric ED visits performed from January to May 2020 confirmed a significant reduction in daily consultations after February, with a considerable percentage of days with ≤ 3 visits/day ( Table 1). Daily pediatric ED consultations significantly varied also considering pre-and post-lockdown beginning period (pre-lockdown, 16 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)…”

Section: Impact Of Covid-19 Pandemic On Pediatric Ed Consultationsmentioning

confidence: 99%

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How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Vierucci¹,

Bacci

Mucaria

et al. 2020

SN Compr. Clin. Med.

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Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), p < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March − 74.6%, April − 71.6%, May − 58.6%). Nasopharyngeal What is Known: Italy was the first European country hit by SARS-CoV-2 infection. Published preliminary Italian data confirmed a general favorable clinical course of COVID-19 in childhood. What is New: Even if COVID-19 pandemic more seriously affected Northern Italy, the admission of children and adolescents to pediatric emergency services significantly changed also in Central Italy with reduced demand and increased appropriateness.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Impact Of Covid-19 Pandemic On Pediatric Ed Consultationsmentioning

confidence: 99%

See 1 more Smart Citation

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Vierucci¹,

Bacci

Mucaria

et al. 2020

SN Compr. Clin. Med.

View full text Add to dashboard Cite

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“…[13][14][15][16][17][18] Additionally, multiple studies have evaluated changes in specific illness and injury patterns in children presenting for care during the pandemic. 14,17,18 Despite the growing body of evidence for a reduction of ED visits in children, 13,[15][16][17]20,21 no published study has focused on changes in critical illness presenting to the pediatric emergency department (PED). Moreover, the impact of public health interventions on the timing of changes in critical illness and injury patterns in children has not been studied.…”

Section: Importancementioning

confidence: 99%

The impact of public health interventions on critical illness in the pediatric emergency department during the SARS‐CoV‐2 pandemic

et al. 2020

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Study objective The impact of public health interventions during the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic on critical illness in children has not been studied. We seek to determine the impact of SARS‐CoV‐2 related public health interventions on emergency healthcare utilization and frequency of critical illness in children. Methods This was an interrupted time series analysis conducted at a single tertiary pediatric emergency department (PED). All patients evaluated by a provider from December 31 through May 14 of 6 consecutive years (2015‐2020) were included. Total patient visits (ED and urgent care), shock trauma suite (STS) volume, and measures of critical illness were compared between the SARS‐CoV‐2 period (December 31, 2019 to May 14, 2020) and the same period for the previous 5 years combined. A segmented regression model was used to explore differences in the 3 outcomes between the study and control period. Results Total visits, STS volume, and volume of critical illness were all significantly lower during the SARS‐CoV‐2 period. During the height of public health interventions, per day there were 151 fewer total visits and 7 fewer patients evaluated in the STS. The odds of having a 24‐hour period without a single critical patient were >5 times higher. Trends appeared to start before the statewide shelter‐in‐place order and lasted for at least 8 weeks. Conclusions In a metropolitan area without significant SARS‐CoV‐2 seeding, the pandemic was associated with a marked reduction in PED visits for critical pediatric illness.

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“…During the Covid-19 pandemic, there has been a clinical epidemiological change about the onset of many diseases: in some countries, a decrease of common paediatric diseases has been reported [2,13], such as asthma and acute respiratory tract infection [14]. Since schools and sport centres closed, the number of acute infections and traumas among children were lower than usual [15].…”

Section: Discussionmentioning

confidence: 99%

Is Covid-19 lockdown related to an increase of accesses for seizures in the emergency department? An observational analysis of a paediatric cohort in the Southern Italy

et al. 2020

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Background The World Health Organization (WHO) declared a global pandemic of Covid-19 on 11 March 2020. The lockdown caused a lifestyle changes: an increase in the use of mobile media devices (MMDs), sleep and psychiatric disorders, incorrect habits regarding food and physical activities. We investigate prevalence of admission for seizures at our emergency department (ED), during Italian lockdown, comparing with that of the same period of the previous year (2019), and the relationship with some lifestyle changes. Methods In this observational study, patients (4–14 years) with seizures that accessed at our ED, during Italian lockdown, were eligible. Non-epileptic events and febrile seizures were excluded. We describe two groups: patients with new-onset seizures and not. Moreover, a questionnaire concerning use of MMDs and sleep habits was administered. Results Fifty-seven patients were included; median age 8.03 years. Considering only paediatric medical emergencies, the prevalence of accesses for seizures was 2.6% (CI 95% 0.020–0.034), while the incidence was 0.94% (CI 95% 0.006–0.0149). There was a statistically significant difference with prevalence of previous years, χ2 102.21 (p = 0.0001). We also reported a difference in daily screen time (DST) (p = 0.001) and total sleep time (TST) (p = 0.045), in all population, between period pre- and during lockdown. A negative correlation between DST and seizures latency (Spearman’s ρ -0.426, p = 0.038) was found. In the two groups, the results were partially overlapping. Conclusions During lockdown period, we assisted to an increase of accesses for seizures. It is conceivable that a sleep time change and/or higher MMD use could act as triggers for seizures.

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The impact of the COVID‐19 lockdown in Italy on a paediatric emergency setting

Cited by 51 publications

References 2 publications

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

The impact of public health interventions on critical illness in the pediatric emergency department during the SARS‐CoV‐2 pandemic

Is Covid-19 lockdown related to an increase of accesses for seizures in the emergency department? An observational analysis of a paediatric cohort in the Southern Italy

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