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. 2021 Jun:5:100081.
doi: 10.1016/j.lanepe.2021.100081. Epub 2021 Mar 18.

Pediatric admissions to emergency departments of North-Western Italy during COVID-19 pandemic: A retrospective observational study

Irene Raffaldi  1 , Emanuele Castagno  1 , Ilaria Fumi  2 , Claudia Bondone  1 , Fulvio Ricceri  3   4 , Luigi Besenzon  5 , Adalberto Brach Del Prever  6 , Pina Capalbo  7 , Gianluca Cosi  8 , Enrico Felici  9 , Patrizia Fusco  10 , Maria Rita Gallina  11 , Franco Garofalo  12 , Paola Gianino  13 , Andrea Guala  14 , Oscar Haitink  15 , Paolo Manzoni  16 , Antonio Marra  17 , Ivana Rabbone  18 , Luca Roasio  19 , Savino Santovito  20 , Alberto Serra  21 , Eleonora Tappi  22 , Gian Maria Terragni  23 , Fabio S Timeus  24 , Flaminia Torielli  25 , Alessandro Vigo  26 , Antonio F Urbino  1 ; ICOPER Study Group
Affiliations

Pediatric admissions to emergency departments of North-Western Italy during COVID-19 pandemic: A retrospective observational study

Irene Raffaldi et al. Lancet Reg Health Eur. 2021 Jun.

Abstract

Background: COVID-19 pandemic caused huge decrease of pediatric admissions to Emergency Department (ED), arising concerns about possible delays in diagnosis and treatment of severe disorders.

Methods: Impact of COVID-19 on Pediatric Emergency Room (ICOPER) was a retrospective multicentre observational study including 23 Italian EDs.All the children <18 years admitted, between March 9th and May 3rd 2020 stratified by age, priority code, cause of admission and outcome have been included and compared to those admitted in the same period of 2019.Our objectives were to assess the characteristics of pediatric admissions to EDs since COVID-19 outbreak until the end of lockdown, and to describe the features of critical children.

Findings: 16,426 children were admitted in 2020, compared to 55,643 in 2019 (-70·48%). Higher reduction was reported in hospitals without Pediatric Intensive Care Unit (PICU) (-73·38%) than in those with PICU (-64·08%) (P<0·0001). Admissions with low priority decreased more than critical ones (-82·77% vs. 44·17% respectively; P<0·0001). Reduction of discharged patients was observed both in hospitals with (-66·50%) and without PICU (-74·65%) (P<0·0001). No difference in the duration of symptoms before admission was reported between 2019 and 2020, with the majority of children accessing within 24 h (55·08% vs. 57·28% respectively; P = 0·2344).

Interpretation: Admissions with low priority decreased significantly more than those with high priority; we suppose that the fear of being infected in hospital maybe overcame the concerns of caregivers. Compared to 2019, no significant referral delay by caregivers was reported. Our data suggest the need of adaptation of EDs and primary care services to different needs of children during COVID-9 pandemic.

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Conflict of interest statement

Nothing to disclose.

Figures

Fig 1
Fig. 1
Causes of pediatric admissions (total number) to Emergency Departments on March 2019 (a) and March 2020 (b).
Fig 2
Fig. 2
Admissions to the Pediatric Emergency Department of hospitals with Pediatric Intensive Care Unit (PICU) compared to hospitals without PICU between March 9th and May 3rd, 2019 vs. March 9th and May 3rd, 2020, stratified by: a. priority code b. age c. outcome.
See this image and copyright information in PMC

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