Abstract
Children have a low risk for severe COVID-19 infections, but indirect consequences of the pandemic may affect their health. We evaluated nationwide data on children’s outpatient visits before and during the first wave of the COVID-19 pandemic in Germany. Data from the National Association of Statutory Health Insurance Physicians for all children with statutory health insurance and at least one physician’s office visit between January 2019 and June 2020 were evaluated for total visits and selected diagnoses for the 2nd quarter of 2019 (8.29 million children, controls) and the 2nd quarter of 2020 (8.5 million, pandemic). Outpatient visits per child fell by 18% during the first wave of the pandemic. Outpatient visits associated with diagnosed infections fell markedly by 51%, particularly for children up to age 5 years for gastroenteritis (73%), otitis media (71%), and streptococcal angina (78%). Outpatient visits for diagnosed chronic physical disorders (diabetes, celiac disease, and hay fever) and mental and behavioral disorders showed little change. Reduced contact between children appears to markedly reduce infection transmission. Infection risks in educational settings should be attenuated after the pandemic through targeted education and counseling and appropriate relationship prevention measures to improve quality of life and opportunities for children and to reduce stress and lost work time for parents.
Highlights
Children are much less likely to be affected by severe COVID-19 than adults [1].contact restrictions implemented as a consequence of the pandemic and further changes in children’s living conditions may affect their mental and physical health and might lead, for example, to reduced physical activity, unfavorable diets, and increased risk of obesity [2,3]
We evaluated the nationwide data of the Kassenärztliche Bundesvereinigung (KBV) in anonymized form, in compliance with data protection regulations, for the population of all children with statutory health insurance in Germany with at least one visit to a medical doctor’s office between January 2019 and June 2020
The number of diagnosed infections fell to 49% from the control period (Figure 1 displays the average prevalences in % on the y-axis and the different diseases in the control and pandemic period on the x-axis; exact means, SD, p-values, and confidence intervals can be found in Supplementary Material Table S1), with a greater decline in children aged 5 years and younger than in older children (55% and 57% in 6–10- and 11–12-year-olds, respectively)
Summary
Contact restrictions implemented as a consequence of the pandemic and further changes in children’s living conditions may affect their mental and physical health and might lead, for example, to reduced physical activity, unfavorable diets, and increased risk of obesity [2,3]. A decrease in inpatient treatment cases in children by up to 45% has been reported in the United States [5] and by 13–16% in Europe [6]. A 45% decrease in outpatient pediatric treatment cases has been reported in the city of New York [7]. We analyzed nationally collected data on children’s outpatient visits in Germany with respect to the frequency of medical presentations and selected diagnoses before and during the COVID-19 pandemic to evaluate the health impact of the pandemic on children
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
