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COVID-19 related reduction in pediatric emergency healthcare utilization – a concerning trend

Christian Dopfer, Martin Wetzke, Anna Zychlinsky Scharff and 7 more

BMC Pediatrics · 2020 · CC BY

doi:10.1186/s12887-020-02303-6

Abstract

Background. The COVID-19 pandemic has disrupted healthcare systems worldwide. In addition to the direct impact of the virus on patient morbidity and mortality, the effect of lockdown strategies on health and healthcare utilization have become apparent. Little is known on the effect of the pandemic on pediatric and adolescent medicine. We examined the impact of the pandemic on pediatric emergency healthcare utilization.

Methods. We conducted a monocentric, retrospective analysis of n = 5,424 pediatric emergency department visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization during the pandemic in 2020 to the same period in 2019.

Results. In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ± SEM 1.5 in 2019 vs. 9.7 ± SEM 1 in 2020, p < 0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs. 23.1% ±SEM 1.7 in 2020, p < 0.01) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p < 0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred.

Conclusions. Our data illustrate a significant decrease in pediatric emergency department visits during the COVID-19 pandemic. Public outreach is needed to encourage parents and guardians to seek medical attention for pediatric emergencies in spite of the pandemic.

References 23

  1. 1.
  2. 2.

    Abrams EM, Greenhawt M. Risk Communication During COVID-19. J Allergy Clin Immunol Pract. 2020;8(6):1791.

    Not in our library10.1016/j.jaip.2020.04.012

  3. 3.

    Zangrillo A, Beretta L, Silvani P, Colombo S, Scandroglio AM, Dell’Acqua A, Fominskiy E, Landoni G, Monti G, Azzolini ML, et al. Fast reshaping of intensive care unit facilities in a large metropolitan hospital in Milan, Italy: facing the COVID-19 pandemic emergency. Crit Care Resusc. 2020;22(2):91.

    Not in our library10.51893/2020.2.pov1

  4. 4.

    Carenzo L, Costantini E, Greco M, Barra FL, Rendiniello V, Mainetti M, Bui R, Zanella A, Grasselli G, Lagioia M, et al. Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia. 2020;75(7):928.

    Not in our library10.1111/anae.15072

  5. 5.

    Spina S, Marrazzo F, Migliari M, Stucchi R, Sforza A, Fumagalli R. The response of Milan’s Emergency Medical System to the COVID-19 outbreak in Italy. Lancet. 2020;395(10227):e49-50.

    Not in our library10.1016/s0140-6736(20)30493-1

  6. 6.
  7. 7.

    Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J. 2020;41(19):1852.

    Not in our library10.1093/eurheartj/ehaa314

  8. 8.

    Feral-Pierssens AL, Claret PG, Chouihed T. Collateral damage of the COVID-19 outbreak: expression of concern. Eur J Emerg Med. 2020;27(4):233.

    Not in our library10.1097/mej.0000000000000717

  9. 9.

    Giamello JD, Abram S, Bernardi S, Lauria G. The emergency department in the COVID-19 era. Who are we missing? Eur J Emerg Med 2020.

    Not in our library10.1097/mej.0000000000000718

  10. 10.

    Tartari F, Guglielmo A, Fuligni F, Pileri A. Changes in emergency service access after spread of COVID19 across Italy. J Eur Acad Dermatol Venereol. 2020;34(8):e350.

    Not in our library10.1111/jdv.16553

  11. 11.

    Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, Lam YM, Chan C, Tsang TC, Tsui M, et al. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment-Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020;13(4):e006631.

    Not in our library10.1161/circoutcomes.120.006631

  12. 12.

    Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health. 2020;4(5):e10-1.

    Not in our library10.1016/s2352-4642(20)30108-5

  13. 13.

    Robert Koch Insitut (RKI). https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Fallzahlen.html. 2020. Last accessed 17 May 2020.

    Not in our library

  14. 14.

    Finset A, Bosworth H, Butow P, Gulbrandsen P, Hulsman RL, Pieterse AH, Street R, Tschoetschel R, van Weert J. Effective health communication - a key factor in fighting the COVID-19 pandemic. Patient Educ Couns. 2020;103(5):873-6.

    Not in our library10.1016/j.pec.2020.03.027

  15. 15.

    Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663-5.

    Not in our library10.1056/nejmc2005073

  16. 16.

    The L. COVID-19: protecting health-care workers. Lancet. 2020;395(10228):922.

    Not in our library10.1016/s0140-6736(20)30644-9

  17. 17.

    World Health Organization Shortage of personal protective equipment endangering health workers worldwide. https://wwwwhoint/news-room/detail/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide 2020. Last accessed 17 May 2020.

    Not in our library

  18. 18.

    Kabesch M, Roth S, Brandstetter S, Hausler S, Juraschko E, Weigl M, Wellmann S, Lang T, Schmidt B, Salzberger B, et al: Successful containment of COVID-19 outbreak in a large maternity and perinatal center while continuing clinical service. Pediatr Allergy Immunol 2020.

    Not in our library10.1111/pai.13265

  19. 19.

    Robert Koch Insitut (RKI). https://influenza.rki.de/maparchive.aspx. 2020. Last accessed 17 May 2020.

    Not in our library

  20. 20.

    European mortality monitoring activity - EUROMOMO. https://euromomo.eu/graphs-and-maps/. 2020. Last accessed 17 May 2020.

    Not in our library

  21. 21.

    Gilbert EH, Lowenstein SR, Koziol-McLain J, Barta DC, Steiner J. Chart Reviews In Emergency Medicine. Annals of Emergency Medicine. 1996;27(3):305-308.

    Not in our library10.1016/s0196-0644(96)70264-0

  22. 22.

    Mockel M, Bachmann U, Behringer W, Pfafflin F, Stegemann MS. How emergency departments prepare for virus disease outbreaks like COVID-19. Eur J Emerg Med. 2020;27(3):161-2.

    Not in our library10.1097/mej.0000000000000703

  23. 23.

    Thomas-Ruddel D, Winning J, Dickmann P, Ouart D, Kortgen A, Janssens U, Bauer M. [Coronavirus disease 2019 (COVID-19): update for anesthesiologists and intensivists March 2020]. Anaesthesist. 2020;69(4):225-35.

    Not in our library10.1007/s00101-020-00758-x

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