Reluctance to seek pediatric care during the COVID-19 pandemic and the risks of delayed diagnosis

Abstract

Since the outbreak of COVID-19 pandemic, the number of cases registered worldwide has risen to over 3 million. While COVID-19 per se does not seem to represent a significant threat to the pediatric population, which generally presents a benign course and a low lethality, the current emergency might negatively affect the care of pediatric patients and overall children welfare. In particular, the fear of contracting COVID-19 may determine a delayed access to pediatric emergency facilities. Present report focuses on the experience of The Children Hospital in Alessandria (northern Italy). The authors document a drop in the number of admissions to the emergency department (A&E) during the lock-down. They will also focus on four emblematic cases of pediatric patients who were seen to our A&E in severe conditions. All these cases share a significant diagnostic delay caused by the parents' reluctance to seek medical attention, seen as a potential risk factor for COVID-19 contagion. None was found positive to all COVID-19 swab or immunologic testing. All in all, our data strongly support the importance of promoting a direct and timely interaction between patients and medical staff, to prevent the fear of COVID-19 from causing more harm than the virus itself.

Keywords: COVID-19; Delayed diagnosis; Pediatric emergency.

Fig. 1

a, histogram showing a drop in the total number of pediatric A&E accesses during March 2019 and March 2020, respectively. b, percent decrease of A&E access number (relative to March 2019) by severity code. Horizontal dashed line shows the average drop (without taking into account the code)