Pediatric admissions to emergency departments of North-Western Italy during COVID-19 pandemic: A retrospective observational study

doi:10.1016/j.lanepe.2021.100081

The Lancet Regional Health - Europe

Volume 5, June 2021, 100081

https://doi.org/10.1016/j.lanepe.2021.100081 Get rights and content

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open access

Abstract

Background

COVID-19 pandemic caused huge decrease of pediatric admissions to Emergency Department (ED), arising concerns about possible delays in diagnosis and treatment of severe disorders.

Methods

Impact of COVID-19 on Pediatric Emergency Room (ICOPER) was a retrospective multicentre observational study including 23 Italian EDs.

All the children <18 years admitted, between March 9th and May 3rd 2020 stratified by age, priority code, cause of admission and outcome have been included and compared to those admitted in the same period of 2019.

Our objectives were to assess the characteristics of pediatric admissions to EDs since COVID-19 outbreak until the end of lockdown, and to describe the features of critical children.

Findings

16,426 children were admitted in 2020, compared to 55,643 in 2019 (-70·48%). Higher reduction was reported in hospitals without Pediatric Intensive Care Unit (PICU) (-73·38%) than in those with PICU (-64·08%) (P<0·0001). Admissions with low priority decreased more than critical ones (-82·77% vs. 44·17% respectively; P<0·0001). Reduction of discharged patients was observed both in hospitals with (-66·50%) and without PICU (-74·65%) (P<0·0001). No difference in the duration of symptoms before admission was reported between 2019 and 2020, with the majority of children accessing within 24 h (55·08% vs. 57·28% respectively; P = 0·2344).

Interpretation

Admissions with low priority decreased significantly more than those with high priority; we suppose that the fear of being infected in hospital maybe overcame the concerns of caregivers. Compared to 2019, no significant referral delay by caregivers was reported. Our data suggest the need of adaptation of EDs and primary care services to different needs of children during COVID-9 pandemic.

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Impact of COVID-19 on Pediatric Emergency Room (ICOPER) Study Group:

Sonia Aguzzi^a, MD; Marco Aicardi^k, MD; Antonella Aimar^e, MD; Luca Baroero^g, MD; Michelangelo Barbagliaⁿ, MD; Stefania Bezzio^q, MD; Giulia Calosso^h, MD; Mario M. Calvo^x, MD; Roberto Cerchio^a, MD; Nicoletta Ceschina^u, MD; Elisa Chioma^b, MD; Margherita Conrieri^a, PhD; Elena Coppo^a, MD; Simona De Franco^o, MD; Barbara De Vito^a, MD; Angelo G. Delmonaco^a, MD; Valeria Di Gianni^f MD; Maria E. Donadio^b, MD; Rachele Gallo^s, MD; Laura Garassino^m, MD; Davide Garelli^a, MD; Emanuela Garrone^a, MD; Marianna Genisio^b, MD; Elena Giachetti^b, MD; Giulia Grasso^a, MD; Barbara Lauria^a, MD; Cinzia Marcianoⁱ, MD; Giuseppina Migliore^a, MD; Maria Angela Militello^p, MD; Ilaria Mussinatto^b, MD; Manuela Pagano^a, PhD; Francesca Romano^b, MD; Lorenza Rossi^b, MD; Roberta Rossi^a, MD; Romina Ruffatto^z, MD; Francesco Tagliaferri^r, MD; Irene Tardivo^a, MD; Alberto Testa^a, MD; Claudia Toppino^a, MD; Claudia Tortone^b, MD; Antonella Tuscano^b, MD; Cristina Vassia^a, MD; Maria Paola Vardeu^a, MD; Antonia Versace^a, MD; Alice Viano^l, MD.

: I, the corresponding author, had final responsibility for the decision to submit for publication.

¹: Co-first authors.