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The impact of COVID-19 on a tertiary care pediatric emergency department

Ilaria Liguoro1, Chiara Pilotto2, Michela Vergine2

  • 1Department of Medical Area - DAME - Division of Pediatrics, University of Udine, P.zzale S. Maria della Misericordia, 15., 33100, Udine, Italy. ilarialiguoro@gmail.com.

European Journal of Pediatrics
|January 7, 2021
PubMed

Insights

COVID-19 quarantine measures drastically reduced pediatric emergency department visits by 73%. Triage categories shifted, with fewer minor cases and more urgent cases, impacting pediatric healthcare utilization.

Area of Science:

  • Pediatric Emergency Medicine
  • Infectious Disease Epidemiology
  • Public Health Policy

Background:

  • The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic necessitated widespread restrictive measures.
  • These public health interventions may alter healthcare-seeking behaviors and utilization patterns, particularly in pediatric emergency settings.

Purpose of the Study:

  • To analyze the impact of SARS-CoV-2 pandemic restrictions on pediatric emergency department (ED) utilization.
  • To investigate changes in patient volume and triage category distribution during the pandemic.

Main Methods:

  • Retrospective review of medical records for a pediatric ED during March-April 2020.
  • Comparison with data from the same periods in 2018 and 2019, and control periods (Jan-Feb, Jul-Aug).

Main Results:

  • A 73% decrease in total ED visits was observed from 2019 to 2020 (3051 vs. 818).
  • Significant shifts in triage categories: a decrease in green-code (minor) cases (0.59-fold) and an increase in yellow-code (urgent) cases (OR 1.46).
  • Discharge diagnoses showed a relative increase in traumatic injuries and a decrease in viral infections.

Conclusions:

  • Pandemic-related quarantine measures significantly reduced pediatric ED visits and altered the nature of cases presenting.
  • The decline may be attributed to reduced acute infections due to social distancing or parental reluctance to visit healthcare settings.
  • Findings highlight the profound impact of public health crises on pediatric emergency care access and patterns.

Keywords:
COVID-19Emergency careInfectious diseasePandemicPediatrics

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