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Italian COVID-19 epidemic: effects on paediatric emergency attendance-a survey in the Emilia Romagna region
Andrea Cella1, Federico Marchetti2, Lorenzo Iughetti3
1Paediatric Emergency Unit, Guglielmo da Saliceto City Hospital, Piacenza, Italy.
Insights
The COVID-19 epidemic caused an 83.8% drop in paediatric emergency department visits in Italy, with a rise in severe cases and delayed care for conditions like poisoning and head injuries.
Area of Science:
- Pediatric Emergency Medicine
- Epidemiology
- Public Health
Background:
- The COVID-19 pandemic significantly impacted healthcare systems globally.
- Paediatric emergency department (ED) attendance patterns may have been altered due to public health measures and parental concerns.
Purpose of the Study:
- To assess the influence of the COVID-19 epidemic on paediatric emergency department attendance in Northern Italy.
- To analyze changes in patient demographics, triage severity, and disease distribution during the initial phase of the epidemic.
Main Methods:
- A comparative survey of paediatric ED data from March 2020 (during the epidemic) and March 2019 (pre-epidemic).
- Data collected included attendance numbers, age/gender distribution, triage scores, hospitalisation rates, and disease types.
- Six paediatric EDs in the Emilia Romagna region participated.
Main Results:
- Paediatric ED attendance decreased by over 83.8% in March 2020 compared to March 2019.
- A higher proportion of patients seen had severe triage scores, and hospitalisation rates significantly increased (p <0.001).
- Significant shifts in disease distribution were observed, with increases in poisonings, psychiatric conditions, head injuries, and fever.
Conclusions:
- The initial COVID-19 epidemic in Italy led to delayed attendance and potentially compromised care for severe paediatric conditions.
- Healthcare providers should recognize this trend and implement strategies to mitigate risks to children, as non-COVID-19 conditions may pose a greater threat.
Objective:
To evaluate the effect of the COVID-19 epidemic on paediatric emergency department (ED) attendance in a region of Northern Italy.
Methods:
A survey was proposed to six out of nine paediatric EDs in the Emilia Romagna region to evaluate attendance data, distribution by age and gender, triage code score, outcome of clinical course, number of hospitalisations and the distribution of patients by disease. Data were collected during March 2020 and compared with that of March 2019.
Results:
A drop in paediatric ED attendance of more than 83.8% was observed, with a higher percentage of infants and severe triage scores. The proportion of patients hospitalised was significantly higher in 2020 than in 2019 (p value: <0.001). The effect size for the comparison of proportions of hospitalised patients was 0.379. Looking at the distribution of attendance by type of disease, a significantly different distribution was highlighted (p value: <0.00001, Cramer's V); there was a greater proportion of patients presenting to paediatric EDs with poisonings (effect size=0.07), psychiatric pathologies (effect size=0.110), head injuries (effect size=0.167) and fever (effect size=0.212).
Conclusions:
Our survey suggests that in the first month of the COVID-19 epidemic in Italy, there has been an increase in delayed attendance and provision of care of potentially severe diseases in paediatric EDs. Hospital and community paediatricians should be aware of this phenomenon and adopt appropriate strategies to prevent this danger, as it may affect children more seriously than COVID-19 itself.
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