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Multicenter Study
. 2020 Dec 23;20(1):562.
doi: 10.1186/s12887-020-02469-z.

Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore

Shu-Ling Chong  1   2 , Jenifer Shui Lian Soo  3 , John Carson Allen Jr  4 , Sashikumar Ganapathy  5   6 , Khai Pin Lee  5   6 , Arif Tyebally  5   6 , Chee Fu Yung  6   7 , Koh Cheng Thoon  6   3 , Yong Hong Ng  6   3 , Jean Yin Oh  6   8 , Oon Hoe Teoh  6   8 , Yee Hui Mok  6   9 , Yoke Hwee Chan  6   3
Affiliations
Multicenter Study

Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore

Shu-Ling Chong et al. BMC Pediatr. .

Abstract

Background: Coronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore.

Methods: We performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs).

Results: We attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7, p < 0.001).

Conclusions: We highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.

Keywords: COVID-19; Child; Health services; Resource utilization.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trend of total ED attendance and total number of patients hospitalized. Bold line shows the daily number of hospitalizations
Fig. 2
Fig. 2
Trend of total, upper and lower respiratory tract infections
See this image and copyright information in PMC

References

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