Abstract
Background: To measure patient flow at our Pediatric Emergency Department (PED) during the Italian lockdown, with particular care in terms of otolaryngological (ENT)-related diagnoses. Methods: A retrospective evaluation of electronic charts of children admitted to our PED in the City Center of Milan (Italy) for any disease. The outcome was to compare distribution of diagnoses performed at our PED during 21 February–3 May 2019 (period 1) to 21 February–3 May 2020 (period 2). Results: A total of 4538 children were evaluated during period 1 compared to 1310 during period 2. A statistically significant overall effect on diagnosis between the study periods was attested (p-value < 0.001; pseudo R2 = 0.010), ENT-related diagnoses being more frequently documented in period 1 (80.4% vs. 19.5%; p-value < 0.001), as well as those related to middle ear infections (92.8% vs. 7.2%; p-value < 0.001). Non-complicated acute otitis media more frequently occurred in period 1 (92.0% vs. 8.0%; p-value < 0.001); no significant difference in the number of complicated middle ear infections occurred (95.8% vs. 4.2%). Conclusions: The exceptional circumstances of the Italian lockdown resulted in a significant decrease in patients’ attendance to our PED, especially when considering diagnoses related to any ENT disorder, middle ear disease, and non-complicated middle ear infection.
Highlights
The SARS-Cov-2 (COVID-19) pandemic lockdown from March to May 2020 brought a deep disruption in social habits and daily activities, as well as a reduction in all medical activities other than those strictly related to emergency or management of COVID-19 patients.Milan, one of the hardest-hit cities during the Italian epidemic, was under lockdown between 9 March and 17 May, during which all elective medical activities were halted to both address the emergent pandemic and avoid unnecessary gatherings [1].The constraints imposed during this period totally altered people’s way of living and consisted in outdoor social distancing and in domiciliary confinement, drastically cutting any outdoor activity and contact with people other than the ones strictly belonging to the domestic setting
We recently documented a significant clinical and subjective improvement in otitis media complaints in otitis-prone children followed at our tertiary outpatient clinic for upper respiratory tract infections who had had a follow-up visit scheduled during the lockdown and were instead reached by means of telemedicine assessment via telephone calls [2]
Demographic data, as well as primary discharge diagnosis based on International Classification of Disease-9 (ICD-9) codes [4], of all the children visiting our Pediatric Emergency Department (PED) were recorded; gathered data were compared with the information relative to the corresponding period in 2019 (21 February–3 May 2019; i.e., period 1)
Summary
The SARS-Cov-2 (COVID-19) pandemic lockdown from March to May 2020 brought a deep disruption in social habits and daily activities, as well as a reduction in all medical activities other than those strictly related to emergency or management of COVID-19 patients. To measure patient flow at our Pediatric Emergency Department (PED) during the Italian lockdown, with particular care in terms of otolaryngological (ENT)-related diagnoses. A statistically significant overall effect on diagnosis between the study periods was attested (p-value < 0.001; pseudo R2 = 0.010), ENT-related diagnoses being more frequently documented in period 1 (80.4% vs 19.5%; p-value < 0.001), as well as those related to middle ear infections (92.8% vs 7.2%; p-value < 0.001). Conclusions: The exceptional circumstances of the Italian lockdown resulted in a significant decrease in patients’ attendance to our PED, especially when considering diagnoses related to any ENT disorder, middle ear disease, and non-complicated middle ear infection
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