[Impact of the COVID-19 pandemic on emergency department: Early findings from a hospital in Madrid]

Abstract

Introduction: SARS-CoV-2, coronavirus that causes coronavirus disease 2019 (COVID-19), was first detected in Spain on 31 January 2020. On 14 March 2020, a state of emergency was declared in Spain in a bid to control the spread of the COVID-19 pandemic in the country. The aim of our study is to analyse the impact on emergency medicine attendance after the national lockdown, as well as the clinical presentation and the management of patients with suspected COVID-19 in the Paediatric Emergency Department.

Patients and methods: This retrospective observational study included children and adolescents under the age of 18, attended in our Paediatric Emergency Department during the period March 14 to April 17, 2020.

Results: A total of 1,666 patients were attended during the study period, 65.4% less than in the same period of 2019. Just over half (51.2%) were males, and mean age was 5.4 years. In triage, 39.9% were high priority levels, 6.5% more than 2019. Most frequent reasons for consultation at the Paediatric Emergency Department were fever (26.5%), respiratory symptoms (16.1%), and trauma (15.2%). A total of 218 patients (13%) received a diagnosis of possible COVID-19, with SARS-CoV-2 infection confirmed in 18.4%, and 23.8% (52/218) were hospitalised. At discharge, 44% (96/218) were diagnosed with lower, and 33.9% (74/218) with upper respiratory infection.

Conclusions: During the SARS-CoV-2 outbreak, the demand for urgent paediatric care decreased, with the proportion of cases with high priority triage levels increasing. Most of the patients with suspected or microbiological confirmation of COVID-19 had mild respiratory symptoms.

Keywords: COVID-19; Medicina pediátrica de urgencias; Paediatric emergency medicine; Pandemia; Pandemics.

Figura 1

Casos diarios de COVID-19 (sospechosos y confirmados mediante PCR) en el Servicio de Urgencias Pediátricas, y correlación con la declaración diaria de casos confirmados en la Comunidad Autónoma de Madrid, durante los primeros 35 días del estado de alarma. Fuente de los datos de la CAM: Ministerio de Sanidad, Servicios Sociales e Igualdad.

Figura 2

Casos acumulados de COVID-19 (sospechosos y confirmados mediante PCR) en el Servicio de Urgencias Pediátricas, y correlación con la acumulación de casos confirmados en la Comunidad Autónoma de Madrid, durante los primeros 35 días del estado de alarma. Fuente de los datos de la CAM: Ministerio de Sanidad, Servicios Sociales e Igualdad.

Figura 3

Flujograma de los pacientes con diagnóstico al alta de enfermedad infecciosa y sospecha/confirmación de COVID-19.