Abstract
BackgroundCOVID-19 pandemic has stretched healthcare system capacities worldwide and deterred people from seeking medical support at Emergency Departments (ED). Nevertheless, population-based studies examining the consequences on children are lacking.MethodsAll ED visits from 2019 to 2020 in Veneto, Italy (4.9 million residents) were collected. Anonymized records of pediatric (≤14 years) ED visits included patient characteristics, arrival mode, triage code, clinical presentation, and discharge mode. Year-on-year variation of the main ED visit characteristics, and descriptive trends throughout the study period have been examined.ResultsOverall, 425,875 ED presentations were collected, 279,481 in 2019, and 146,394 in 2020 (− 48%), with a peak (− 79%) in March–April (first pandemic wave), and a second peak (below − 60%) in November–December (second pandemic wave). Burn or trauma, and fever were the two most common clinical presentations. Visits for nonurgent conditions underwent the strongest reduction during both pandemic waves, while urgent conditions reduced less sharply. ED arrival by ambulance was more common in 2020 (4.5%) than 2019 (3.5%), with a higher proportion of red triage codes (0.5%, and 0.4% respectively), and hospitalizations following ED discharge (9.1%, and 5.9% respectively).ConclusionSince the beginning of the COVID-19 pandemic, pediatric ED presentations underwent a steeper reduction than that observed for adults. Lockdown and fear of contagion in hospital-based services likely deterred parents from seeking medical support for their children. Given COVID-19 could become endemic, it is imperative that public health experts guarantee unhindered access to medical support for urgent, and less urgent health conditions, while minimizing infectious disease risks, to prevent children from suffering direct and indirect consequences of the pandemic.
Highlights
Since December 2019, 150 million people worldwide have been infected with SARS-CoV-2, and 3.15 million have died as of April 2021 [1]
After the first clusters of COVID-19 cases were detected in Italy in late February 2020 [5], the government implemented social distancing rules and imposed strict restrictions on individual mobility for the whole country starting from March 10th
In Italy, as in other hard-hit countries, the measures taken to cope with the pandemic led to a decline in the access rates to numerous healthcare services, including general practitioner and specialist visits, hospital admissions [6, 7], and emergency department (ED) visits [6, 8, 9]
Summary
Since December 2019, 150 million people worldwide have been infected with SARS-CoV-2, and 3.15 million have died as of April 2021 [1]. Sixty million people were placed under lockdown in the attempt to counter the disease’s spread, and contain the burden, especially on hospital-based services and intensive care units [2]. Intensive care units and hospitals dedicated to COVID-19 patients experienced a surge of admissions, while the use of other healthcare services decreased. In Italy, as in other hard-hit countries, the measures taken to cope with the pandemic led to a decline in the access rates to numerous healthcare services, including general practitioner and specialist visits, hospital admissions [6, 7], and emergency department (ED) visits [6, 8, 9]. Population-based studies examining the consequences on children are lacking
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