Paediatric ED utilisation in the early phase of the COVID-19 pandemic

Area of Science:

• Global Health
• Pediatric Emergency Medicine
• Epidemiology

Background:

• Previous epidemics like influenza have historically increased pediatric emergency department (ED) patient volumes.
• The impact of the COVID-19 pandemic on pediatric ED utilization remained uncertain during its initial phase.

Purpose of the Study:

• To investigate international variations in pediatric ED utilization and patient disposition during the early COVID-19 pandemic.
• To compare trends across five major children's hospitals in different global locations.

Main Methods:

• Data on ED volume, patient acuity, and disposition (hospitalization and ICU admission) were collected from December 1, 2017, to August 10, 2020.
• Utilized paired t-tests or Wilcoxon signed rank tests to analyze percentage changes in ED metrics.
• Included data from children's hospitals in Boston (USA), Singapore, Melbourne (Australia), Seattle (USA), and Paris (France).

Main Results:

• A substantial decrease in overall pediatric ED volume was observed across all five hospitals during the early pandemic compared to previous years.
• Responses in ED volume by acuity level, hospitalization, and intensive care unit (ICU) admission showed variability among the participating hospitals.
• Paris experienced a notable 2% increase in ICU admissions, an exception to the general trend. By August 2020, ED volumes had increased but remained below pre-pandemic baseline levels.

Conclusions:

• Pediatric EDs in the studied international locations exhibited varied reductions in patient volume, acuity, and disposition during the initial months of the COVID-19 pandemic.
• The findings highlight differential impacts of the pandemic on pediatric emergency care across different healthcare systems.