Where have the children with epilepsy gone? An observational study of seizure-related accesses to emergency department at the time of COVID-19

Davico, Chiara; Marcotulli, Daniele; Lux, Caterina; Calderoni, Dario; Terrinoni, Arianna; Santo, F. Di; Ricci, Federica; Vittorini, Roberta; Amianto, Federico; Urbino, Antonio; Ferrara, Mauro; Vitiello, Benedetto

doi:10.1016/j.seizure.2020.09.025

Cited by 25 publications

(36 citation statements)

References 10 publications

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“…Although evidence has shown that the reduction in Em presentations was caused by a combination of factors, including a reduction in the incidence of respiratory diseases, reduction in injuries from outdoor activities, parents' hesitancy to visit the hospital during the pandemic, and/or evaluating a condition as non-emergent (4,(11)(12)(13)(14)(15)18).…”

Section: Discussionmentioning

confidence: 99%

“…A great concern with regard to the decrease in pediatric Em visits was that patients who needed to receive Em healthcare did not visit the hospital, resulting in delayed treatment and adverse health outcomes (4,(11)(12)(13)(14)(15)18). In addition to differences in the disease spectrum, one large difference between adult and pediatric Em attendance is that the decision regarding pediatric attendance is usually made by the child's parents or guardians.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, for the healthcare system to evaluate the impact of COVID-19 on pediatric healthcare and develop response plans, investigations focusing on changes in pediatric healthcare utilization after the COVID-19 pandemic outbreak are needed. Efforts around the world have been made to evaluate such changes (4,9,(11)(12)(13)(14)(15)(16)(17)(18). Many studies have reported decreases in the utilization of pediatric emergency services (4,(11)(12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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Changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic: a multi-center cross-sectional study

Yan¹,

Li²,

Lu³

et al. 2021

Transl Pediatr

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Background: The coronavirus disease 2019 (COVID-19) pandemic brought remarkable disruption to the ways in which healthcare was delivered. This study aimed to examine changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic.Methods: An electronic survey was conducted among 142 hospitals in Hunan Province, China. Using data from January 1 to April 30, 2019 as a reference, the changes in the number of visits for different types of pediatric healthcare between January 1 and April 30, 2020 were calculated. Changes in the number of admissions for infections and injuries were also evaluated. Results:The total number of pediatric healthcare presentations decreased by 53.3% in the first four months of 2020. The most remarkable reductions were observed in the utilization of emergency room (ranging from -45.7% to -94.9% among three hospital levels) and observation room (-55.8% to -77.7%); neonatal inpatient care experienced the smallest decreases (-21.2% to -25.5%). Approximately 85% of the total reduction in the number of pediatric inpatient admissions was attributable to the reduction in admissions for infections. A 13.3% increase in the number of admissions for injuries was observed among third-level hospitals. Conclusions:The utilization of all types of pediatric healthcare services in Hunan Province declined markedly after the outbreak of COVID-19. The reasons, consequences, and responses to these changes should be addressed in future studies and actions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic: a multi-center cross-sectional study

Yan¹,

Li²,

Lu³

et al. 2021

Transl Pediatr

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“…Although the North-West of Italy was one of the most impacted regions in the spring of 2020, almost all Italian national territory hospitals have experienced a significant reduction in the number of emergency department (ED) presentations [7] , [8] , [9] , even in areas of low SARS-CoV-2 prevalence. This situation provides an exceptional opportunity to study the role of the ED in current healthcare systems [10] .…”

Section: Introductionmentioning

confidence: 99%

Examination of the relationship between emergency department presentations and population mortality: a multicenter analysis of emergency department presentations during the COVID-19 pandemic

Solbiati

Russo

Beverina

et al. 2021

European Journal of Internal Medicine

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Background : In the spring of 2020, Italy experienced a significant reduction in the number of emergency department (ED) presentations during the first wave of the COVID-19 pandemic. If ED access has an impact on patients’ prognosis, such a reduction in ED presentations would be expected to correlate with a parallel increase in the mortality rate of the corresponding population. The aim of the present study was to evaluate the impact of reduced ED presentations on the all-cause mortality of the general population. Methods Absolute and relative variation in ED accesses from March 1 to April 30 of both 2019 and 2020 in three hub hospitals in areas with different COVID-19 prevalence and age-standardized mortality data from January 1 to June 30 in 2019 and 2020 of the same areas were evaluated. Results : During March and April 2020, ED consults were decreased of approximately 50% in all three hospitals, as compared with the same months in 2019. There was a marked increase in cumulative mortality in Milan (high SARS-CoV2 infection spread zone) compared with the same period in 2019. In the other two municipalities (Ferrara and Perugia), which had intermediate and low levels of infection spread, the mortality in 2020 was not substantially changed from that of 2019. Conclusions : Taking into account the increase in mortality due to SARS-CoV-2, reductions in ED access did not seem to affect death rates. If this finding will be confirmed, ED organization and access would need to be reconsidered.

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“…Some studies have already analyzed the impact of the COVID-19 outbreak on patients with epilepsy. However, these studies were mainly questionnaire-based [ 11 ] or carried out in a small sample focusing on assessing either the risk of relapses [ 6 , 12 , 13 ] or anti-seizure medication (ASM) adherence during the first COVID-19 outbreak [ 14 ]. To the best of our knowledge, information on ASM use and emergency department (ED) access for epilepsy during the whole of the COVID-19 waves is still scarce and deserves careful evaluation.…”

Section: Introductionmentioning

confidence: 99%

Impact of COVID-19 Lockdown, during the Two Waves, on Drug Use and Emergency Department Access in People with Epilepsy: An Interrupted Time-Series Analysis

Antonazzo

Fornari

Maumus-Robert

et al. 2021

IJERPH

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Background: In 2020, during the COVID-19 pandemic, Italy implemented two national lockdowns aimed at reducing virus transmission. We assessed whether these lockdowns affected anti-seizure medication (ASM) use and epilepsy-related access to emergency departments (ED) in the general population. Methods: We performed a population-based study using the healthcare administrative database of Tuscany. We defined the weekly time series of prevalence and incidence of ASM, along with the incidence of epilepsy-related ED access from 1 January 2018 to 27 December 2020 in the general population. An interrupted time-series analysis was used to assess the effect of lockdowns on the observed outcomes. Results: Compared to pre-lockdown, we observed a relevant reduction of ASM incidence (0.65; 95% Confidence Intervals: 0.59–0.72) and ED access (0.72; 0.64–0.82), and a slight decrease of ASM prevalence (0.95; 0.94–0.96). During the post-lockdown the ASM incidence reported higher values compared to pre-lockdown, whereas ASM prevalence and ED access remained lower. Results also indicate a lower impact of the second lockdown for both ASM prevalence (0.97; 0.96–0.98) and incidence (0.89; 0.80–0.99). Conclusion: The lockdowns implemented during the COVID-19 outbreaks significantly affected ASM use and epilepsy-related ED access. The potential consequences of these phenomenon are still unknown, although an increased incidence of epilepsy-related symptoms after the first lockdown has been observed. These findings emphasize the need of ensuring continuous care of epileptic patients in stressful conditions such as the COVID-19 pandemic.

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Where have the children with epilepsy gone? An observational study of seizure-related accesses to emergency department at the time of COVID-19

Cited by 25 publications

References 10 publications

Changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic: a multi-center cross-sectional study

Changes in pediatric healthcare utilization in Hunan Province, China, during the COVID-19 pandemic: a multi-center cross-sectional study

Examination of the relationship between emergency department presentations and population mortality: a multicenter analysis of emergency department presentations during the COVID-19 pandemic

Impact of COVID-19 Lockdown, during the Two Waves, on Drug Use and Emergency Department Access in People with Epilepsy: An Interrupted Time-Series Analysis

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