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. 2021 Oct;110(10):2796-2801.
doi: 10.1111/apa.16019. Epub 2021 Jul 8.

Delayed presentation of children to the emergency department during the first wave of COVID-19 pandemic in Italy: Area-based cohort study

Franca Rusconi  1   2 , Valeria Di Fabrizio  3 , Monia Puglia  2 , Michela Sica  1 , Rita De Santis  4 , Stefano Masi  4 , Luigi Gagliardi  5   6
Affiliations

Delayed presentation of children to the emergency department during the first wave of COVID-19 pandemic in Italy: Area-based cohort study

Franca Rusconi et al. Acta Paediatr. 2021 Oct.

Abstract

Aim: To ascertain a delay in attendances to the emergency department (ED) during 2020 lockdown.

Methods: Area-based cohort study on paediatric (0-15 years) attendances resulting in hospital admission in Tuscany, Italy, in February-May 2020, and the corresponding periods in 2018-19. We analysed times from symptom onset to arrival, the odds of arriving late (>90th centile of time) and paediatricians' judgements of a late presentation by logistic models.

Results: As expected, ED attendance fell sharply (-62%) in 2020 vs 2018-19. As for cases studied (455 in 2020 and 1161 in 2018-19), we documented a delay in arrival to the ED in 2020 versus 2018-19 for several groups of diagnoses, namely gastroenteritis, sepsis, wounds, burns and infections overall. Time to presentation over 90th centile was also higher in 2020 (odds ratio, OR: 1.44; 95% confidence interval: 1.00, 2.06), as were paediatricians' judgements of a late arrival (18.9% of cases in 2020 vs. 13.4% in 2018-19; OR: 1.58; 1.14, 2.19) CONCLUSION: In a population-based cohort, delayed attendances to ED ascertained both subjectively and objectively convey the message to families and to paediatricians to seek hospital care in case of severe or unremitting symptoms and not to wait longer than they normally would.

Keywords: COVID-19; delayed attendance; emergency medicine; epidemiology; public health.

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Conflict of interest statement

The authors have no conflicts of interests to declare.

Figures

FIGURE 1
FIGURE 1
Emergency department paediatric attendance in 2020 and in 2018–2019 by week; data averaged over prior 7 days
See this image and copyright information in PMC

References

    1. Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109:1088–1095. - PMC - PubMed
    1. Viner RM, Mytton OT, Bonell C, et al. Susceptibility to SARS‐CoV‐2 infection among children and adolescents compared with adults: a systematic review and meta‐analysis. JAMA Pediatr. 2021;2021(175):212. - PMC - PubMed
    1. Guessoum SB, Lachal J, Radjack R, et al. Adolescent psychiatric disorders during the COVID‐19 pandemic and lockdown. Psychiatry Res. 2020;291:113264. - PMC - PubMed
    1. McDonald HI, Tessier E, White JM, et al. Early impact of the coronavirus disease (COVID‐19) pandemic and physical distancing measures on routine childhood vaccinations in England, January to April 2020. Euro Surveill. 2020;25:2000848. - PMC - PubMed
    1. Lazzerini M, Barbi E, Apicella A, Marchetti F, Cardinale F, Trobia G. Delayed access or provision of care in Italy resulting from fear of COVID‐19. Lancet Child Adolesc Health. 2020;4:e10–e11. - PMC - PubMed