Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children's hospital.
Identifieur interne : 000349 ( Main/Exploration ); précédent : 000348; suivant : 000350Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children's hospital.
Auteurs : Umberto Raucci [Italie] ; Anna Maria Musolino [Italie] ; Domenico Di Lallo [Italie] ; Simone Piga [Italie] ; Maria Antonietta Barbieri [Italie] ; Mara Pisani [Italie] ; Francesco Paolo Rossi [Italie] ; Antonino Reale [Italie] ; Marta Luisa Ciofi Degli Atti [Italie] ; Alberto Villani [Italie] ; Massimiliano Raponi [Italie]Source :
- Italian journal of pediatrics [ 1824-7288 ] ; 2021.
Abstract
BACKGROUND
Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children's hospital, composed by two different pediatric centers, one located in Rome's city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED's) and urgent hospitalizations compared to prepandemic period.
METHODS
The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics.
RESULTS
The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access.
CONCLUSIONS
In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn't demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.
DOI: 10.1186/s13052-021-00976-y
PubMed: 33514391
Affiliations:
Links toward previous steps (curation, corpus...)
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wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. umberto.raucci@opbg.net.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Musolino, Anna Maria" sort="Musolino, Anna Maria" uniqKey="Musolino A" first="Anna Maria" last="Musolino">Anna Maria Musolino</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Di Lallo, Domenico" sort="Di Lallo, Domenico" uniqKey="Di Lallo D" first="Domenico" last="Di Lallo">Domenico Di Lallo</name><affiliation wicri:level="3"><nlm:affiliation>Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Piga, Simone" sort="Piga, Simone" uniqKey="Piga S" first="Simone" last="Piga">Simone Piga</name><affiliation wicri:level="3"><nlm:affiliation>Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Barbieri, Maria Antonietta" sort="Barbieri, Maria Antonietta" uniqKey="Barbieri M" first="Maria Antonietta" last="Barbieri">Maria Antonietta Barbieri</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Pisani, Mara" sort="Pisani, Mara" uniqKey="Pisani M" first="Mara" last="Pisani">Mara Pisani</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Rossi, Francesco Paolo" sort="Rossi, Francesco Paolo" uniqKey="Rossi F" first="Francesco Paolo" last="Rossi">Francesco Paolo Rossi</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Reale, Antonino" sort="Reale, Antonino" uniqKey="Reale A" first="Antonino" last="Reale">Antonino Reale</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Ciofi Degli Atti, Marta Luisa" sort="Ciofi Degli Atti, Marta Luisa" uniqKey="Ciofi Degli Atti M" first="Marta Luisa" last="Ciofi Degli Atti">Marta Luisa Ciofi Degli Atti</name><affiliation wicri:level="3"><nlm:affiliation>Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Villani, Alberto" sort="Villani, Alberto" uniqKey="Villani A" first="Alberto" last="Villani">Alberto Villani</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Raponi, Massimiliano" sort="Raponi, Massimiliano" uniqKey="Raponi M" first="Massimiliano" last="Raponi">Massimiliano Raponi</name><affiliation wicri:level="3"><nlm:affiliation>Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author></analytic><series><title level="j">Italian journal of pediatrics</title><idno type="eISSN">1824-7288</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children's hospital, composed by two different pediatric centers, one located in Rome's city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED's) and urgent hospitalizations compared to prepandemic period.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn't demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33514391</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>30</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1824-7288</ISSN><JournalIssue CitedMedium="Internet"><Volume>47</Volume><Issue>1</Issue><PubDate><Year>2021</Year><Month>Jan</Month><Day>29</Day></PubDate></JournalIssue><Title>Italian journal of pediatrics</Title><ISOAbbreviation>Ital J Pediatr</ISOAbbreviation></Journal><ArticleTitle>Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children's hospital.</ArticleTitle><Pagination><MedlinePgn>21</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13052-021-00976-y</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children's hospital, composed by two different pediatric centers, one located in Rome's city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED's) and urgent hospitalizations compared to prepandemic period.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn't demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Raucci</LastName><ForeName>Umberto</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. umberto.raucci@opbg.net.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Musolino</LastName><ForeName>Anna Maria</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Di Lallo</LastName><ForeName>Domenico</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Piga</LastName><ForeName>Simone</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barbieri</LastName><ForeName>Maria Antonietta</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pisani</LastName><ForeName>Mara</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rossi</LastName><ForeName>Francesco Paolo</ForeName><Initials>FP</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reale</LastName><ForeName>Antonino</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ciofi Degli Atti</LastName><ForeName>Marta Luisa</ForeName><Initials>ML</Initials><AffiliationInfo><Affiliation>Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Villani</LastName><ForeName>Alberto</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raponi</LastName><ForeName>Massimiliano</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>01</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Ital J Pediatr</MedlineTA><NlmUniqueID>101510759</NlmUniqueID><ISSNLinking>1720-8424</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Children</Keyword><Keyword MajorTopicYN="N">Diagnostic delay</Keyword><Keyword MajorTopicYN="N">Emergency department</Keyword><Keyword 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Director-General’s opening remarks at the media briefing on COVID- 19 – 11 March 2020. 2020. Available at: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19%2D%2D-11-march-2020 . Accessed 22 Jul 2020.</Citation></Reference><Reference><Citation>Protezione Civile. Chronology of main steps and legal acts taken by the Italian Government for the containment of the COVID-19 epidemiological emergency . Available from : http://www.protezionecivile.gov.it/documents/20182/1227694/Summary+of+measures+taken+against+the+spread+of+C-19/c16459ad-4e52-4e90-90f3-c6a2b30c17eb . Accessed 5 Aug 2020.</Citation></Reference><Reference><Citation>Castagnoli R, Votto M, Licari A, et al. Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr. 2020;2. https://doi.org/10.1001/jamapediatrics.2020.1467 .</Citation></Reference><Reference><Citation>The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. Vital surveillances: the epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) — China, 2020. China CDC Weekly. 2020;2:113–22 http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51 . Accessed 14 Sept 2020.</Citation><ArticleIdList><ArticleId IdType="doi">10.46234/ccdcw2020.032</ArticleId></ArticleIdList></Reference><Reference><Citation>COVID-19 National Incident Room Surveillance Team. COVID-19, Australia: Epidemiology Report 14 (Reporting week to 23:59 AEST 3 May 2020) [published correction appears in Commun Dis Intell (2018). 2020 May 15;44]. Commun Dis Intell (2018). 2020;44. https://doi.org/10.33321/cdi.2020.44.42 .</Citation></Reference><Reference><Citation>CDC COVID-19 Response Team. Coronavirus disease 2019 in children – United States, February 12–April 2, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:422–6. https://doi.org/10.15585/mmwr.mm6914e4 .</Citation><ArticleIdList><ArticleId IdType="doi">10.15585/mmwr.mm6914e4</ArticleId><ArticleId IdType="pmcid">7147903</ArticleId></ArticleIdList></Reference><Reference><Citation>Centers for Disease Control and Prevention. Provisional COVID-19 death counts by sex, age, and state from the National Center for Health Statistics. Available at: https://data.cdc.gov/NCHS/Provisional-COVID-19-Death-Counts-by-Sex-Age-and-S/9bhg-hcku . Accessed 22 Jul 2020.</Citation></Reference><Reference><Citation>Devulapalli CS. COVID-19 a mild disease in children. Tidsskr Nor Laegeforen. 2020;140(6). https://doi.org/10.4045/tidsskr.20.0231 .</Citation></Reference><Reference><Citation>Istituto Superiore di Sanità. Sorveglianza Integrata COVID-19 in Italia; 2020. https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_7-luglio-2020.pdf . Accessed 17 Jul 2020.</Citation></Reference><Reference><Citation>Critical preparedness, readiness and response actions for COVID-19 Interim guidance 24 June, 2020. https://www.who.int/publications/i/item/critical-preparedness-readiness-and-response-actions-for-covid-19 . Accessed 22 Jul 2020.</Citation></Reference><Reference><Citation>Bressan S, Buonsenso D, Farrugia R, Parri N, Oostenbrink R, Titomanlio L, et al. Preparedness and response to Pediatric CoVID-19 in European Emergency Departments: a survey of the REPEM and PERUKI networks [published online ahead of print, 2020 May 15]. Ann Emerg Med. 2020. https://doi.org/10.1016/j.annemergmed.2020.05.018 .</Citation></Reference><Reference><Citation>Freund Y. The challenge of emergency medicine facing the COVID-19 outbreak. Eur J Emerg Med. 2020;27:155. https://doi.org/10.1097/MEJ.0000000000000699 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1097/MEJ.0000000000000699</ArticleId><ArticleId IdType="pubmed">32205709</ArticleId></ArticleIdList></Reference><Reference><Citation>Walker DM, Tolentino VR. COVID-19: the impact on pediatric emergency care. Pediatr Emerg Med Pract. 2020;17(Suppl 6–1):1–27.</Citation><ArticleIdList><ArticleId IdType="pubmed">32549038</ArticleId></ArticleIdList></Reference><Reference><Citation>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 Heal. 2020;4642:2019–20. https://doi.org/10.1016/S2352-4642(20)30108-5 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/S2352-4642(20)30108-5</ArticleId></ArticleIdList></Reference><Reference><Citation>Ciacchini B, Tonioli F, Marciano C, Faticato MG, Borali E, Pini Prato A, et al. Reluctance to seek pediatric care during the COVID-19 pandemic and the risks of delayed diagnosis. Ital J Pediatr. 2020;46:87. https://doi.org/10.1186/s13052-020-00849-w .</Citation><ArticleIdList><ArticleId IdType="doi">10.1186/s13052-020-00849-w</ArticleId><ArticleId IdType="pubmed">32600464</ArticleId><ArticleId IdType="pmcid">7322712</ArticleId></ArticleIdList></Reference><Reference><Citation>Lynn RM, Avis JL, Lenton S, Amin-Chowdhury Z, Ladhani SN. Delayed access to care and late presentations in children during the COVID-19 pandemic: a snapshot survey of 4075 paediatricians in the UK and Ireland. Arch Dis Child. 2020;archdischild-2020-319848. https://doi.org/10.1136/archdischild-2020-319848 .</Citation></Reference><Reference><Citation>Snapiri O, Rosenberg Danziger C, Krause I, Kravarusic D, Yulevich A, Balla U, et al. Delayed diagnosis of paediatric appendicitis during the COVID-19 pandemic. Acta Paediatr. 2020;109:1672–6. https://doi.org/10.1111/apa.1537621 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1111/apa.1537621</ArticleId><ArticleId IdType="pubmed">32460364</ArticleId></ArticleIdList></Reference><Reference><Citation>Health Policy team. Delayed access to care for children during COVID-19: our role as paediatricians - position statement. RCPCH 2020. https://www.rcpch.ac.uk/resources/delayed-presentation-during-covid-19-position . Accessed 14 Sept 2020.</Citation></Reference><Reference><Citation>Wise J. Covid-19: Delays in attending emergency departments may have contributed to deaths of nine children. BMJ. 2020;369:m2624. Published 2020 Jun 30. https://doi.org/10.1136/bmj.m2624 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1136/bmj.m2624</ArticleId><ArticleId IdType="pubmed">32606039</ArticleId></ArticleIdList></Reference><Reference><Citation>Regione Lazio. Indicazioni operative per la gestione e la sorveglianza dei casi sospetti di infezione da nuovo Coronavirus (2019 - nCoV). Prot. n. 69913. 2020. Available at: http://www.regione.lazio.it/rl_sanita/?vw=documentazioneDettaglio&id=53031 . Accessed 24 Jan 2020.</Citation></Reference><Reference><Citation>Cozzi G, Zanchi C, Giangreco M, Rabach I, Calligaris L, Giorgi R, et al. The impact of the COVID-19 lockdown in Italy on a pediatric emergency setting. Acta Paediatr. 2020;29. https://doi.org/10.1111/apa.15454 .</Citation></Reference><Reference><Citation>Iozzi L, Brambilla I, Foiadelli T, Marseglia GL, Ciprandi G. Paediatric emergency department visits fell by more than 70% during the COVID-19 lockdown in Northern Italy [published online ahead of print, 2020 Jul 4]. Acta Paediatr. 2020. https://doi.org/10.1111/apa.15458 .</Citation></Reference><Reference><Citation>Pata D, Gatto A, Buonsenso D, Chiaretti A. A COVID-19 outbreak's lesson: Best use of the paediatric emergency department [published online ahead of print, 2020 Jun 2]. Acta Paediatr. 2020. https://doi.org/10.1111/apa.15386 .</Citation></Reference><Reference><Citation>O'Cathain A, Connell J, Long J, Coster J. Clinically unnecessary’ use of emergency and urgent care: a realist review of patients’ decision making. Health Expect. 2020;23:19–40. https://doi.org/10.1111/hex.1299525 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1111/hex.1299525</ArticleId><ArticleId IdType="pubmed">31663219</ArticleId></ArticleIdList></Reference><Reference><Citation>Angoulvant F, Ouldali N, Yang DD, Filser M, Gajdos V, Rybak A, et al. COVID-19 pandemic: Impact caused by school closure and national lockdown on pediatric visits and admissions for viral and non-viral infections, a time series analysis. Clin Infect Dis. 2020:ciaa710. https://doi.org/10.1093/cid/ciaa710 .</Citation></Reference><Reference><Citation>Kenyon CC, Hill DA, Henrickson SE, Bryant-Stephens TC, Zorc JJ. Initial effects of the COVID-19 pandemic on pediatric asthma emergency department utilization. J Allergy Clin Immunol Pract. 2020;8:2774–6.e1. https://doi.org/10.1016/j.jaip.2020.05.045 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/j.jaip.2020.05.045</ArticleId><ArticleId IdType="pubmed">32522565</ArticleId></ArticleIdList></Reference><Reference><Citation>Taquechel K, Diwadkar AR, Sayed S, Dudley JW, Grundmeier RW, Kenyon CC, et al. Pediatric asthma health care utilization, viral testing, and air pollution changes during the COVID-19 pandemic. J Allergy Clin Immunol Pract. 2020;8:3378–87.e11. https://doi.org/10.1016/j.jaip.2020.07.057 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/j.jaip.2020.07.057</ArticleId><ArticleId IdType="pubmed">32827728</ArticleId><ArticleId IdType="pmcid">7438361</ArticleId></ArticleIdList></Reference><Reference><Citation>Dror AA, Eisenbach N, Marshak T, Layous E, Zigron A, Shivatzki S, et al. Reduction of allergic rhinitis symptoms with face mask usage during the COVID-19 pandemic. J Allergy Clin Immunol Pract. 2020;8:3590–3. https://doi.org/10.1016/j.jaip.2020.08.035 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1016/j.jaip.2020.08.035</ArticleId><ArticleId IdType="pubmed">32889221</ArticleId><ArticleId IdType="pmcid">7467086</ArticleId></ArticleIdList></Reference><Reference><Citation>Ciofi Degli Atti ML, Campana A, Muda AO, Concato C, Ravà L, Ricotta L, et al. Facing SARS-CoV-2 pandemic at a COVID-19 regional children’s hospital in Italy. Pediatr Infect Dis J. 2020;39:e221–e5. https://doi.org/10.1097/INF.0000000000002811 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1097/INF.0000000000002811</ArticleId><ArticleId IdType="pubmed">32639459</ArticleId></ArticleIdList></Reference><Reference><Citation>Camasso-Richardson K, Wilde JA, Petrack EM. Medically unnecessary pediatric ambulance transports: a medical taxi service? Acad Emerg Med. 1997;4:1137–41. https://doi.org/10.1111/j.1553-2712.1997.tb03696.x .</Citation><ArticleIdList><ArticleId IdType="doi">10.1111/j.1553-2712.1997.tb03696.x</ArticleId><ArticleId IdType="pubmed">9408429</ArticleId></ArticleIdList></Reference><Reference><Citation>Kost S, Arruda J. Appropriateness of ambulance transportation to a suburban pediatric emergency department. Prehosp Emerg Care. 1999;3:187–90. https://doi.org/10.1080/10903129908958934 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1080/10903129908958934</ArticleId><ArticleId IdType="pubmed">10424853</ArticleId></ArticleIdList></Reference><Reference><Citation>Lowthian JA, Cameron PA, Stoelwinder JU, Curtis A, Currell A, Cooke MW, et al. Increasing utilisation of emergency ambulances. Aust Health Rev. 2011;35:63–9. https://doi.org/10.1071/AH09866 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1071/AH09866</ArticleId><ArticleId IdType="pubmed">21367333</ArticleId></ArticleIdList></Reference><Reference><Citation>Poryo M, Burger M, Wagenpfeil S, Ziegler B, Sauer H, Flotats-Bastardas M, Grundmann U, Zemlin M, Meyer S. Assessment of inadequate use of pediatric emergency medical transport services: the pediatric emergency and ambulance critical evaluation (PEACE) study. Front Pediatr. 2019;7:442. https://doi.org/10.3389/fped.2019.00442 .</Citation><ArticleIdList><ArticleId IdType="doi">10.3389/fped.2019.00442</ArticleId><ArticleId IdType="pubmed">31709211</ArticleId><ArticleId IdType="pmcid">6823188</ArticleId></ArticleIdList></Reference><Reference><Citation>Uscher-Pines L, Pines J, Kellermann A, Gillen E, Mehrotra A. Emergency department visits for nonurgent conditions: systematic literature review. Am J Manag Care. 2013;19:47–59.</Citation><ArticleIdList><ArticleId IdType="pubmed">23379744</ArticleId><ArticleId IdType="pmcid">4156292</ArticleId></ArticleIdList></Reference><Reference><Citation>Paul JE, Zhu KY, Meckler GD, Park DK, Doan Q. Assessing appropriateness of pediatric emergency department visits: is it even possible? [published online ahead of print, 2020 Feb 3]. CJEM. 2020:1–4. https://doi.org/10.1017/cem.2019.473 .</Citation></Reference><Reference><Citation>Isba R, Edge R, Jenner R, Broughton E, Francis N, Butler J. Where have all the children gone? Decreases in paediatric emergency department attendances at the start of the COVID-19 pandemic of 2020. Arch Dis Child. 2020;105:704. https://doi.org/10.1136/archdischild-2020-3193853 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1136/archdischild-2020-3193853</ArticleId><ArticleId IdType="pubmed">32376695</ArticleId></ArticleIdList></Reference><Reference><Citation>Dann L, Fitzsimons J, Gorman KM, Hourihane J, Okafor I. Disappearing act: COVID-19 and paediatric emergency department attendances. Arch Dis Child. 2020;105:810–1. https://doi.org/10.1136/archdischild-2020-319654 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1136/archdischild-2020-319654</ArticleId><ArticleId IdType="pubmed">32518141</ArticleId><ArticleId IdType="pmcid">7316106</ArticleId></ArticleIdList></Reference><Reference><Citation>Raucci U, Della Vecchia N, Ossella C, Paolino MC, Villa MP, Reale A, et al. Management of Childhood Headache in the emergency department. Review of the Literature. Front Neurol. 2019;10:886. https://doi.org/10.3389/fneur.2019.00886 .</Citation><ArticleIdList><ArticleId IdType="doi">10.3389/fneur.2019.00886</ArticleId><ArticleId IdType="pubmed">31507509</ArticleId><ArticleId IdType="pmcid">6716213</ArticleId></ArticleIdList></Reference><Reference><Citation>Papetti L, Loro PAD, Tarantino S, Grazzi L, Guidetti V, Parisi P, et al. I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children. Cephalalgia. 2020;40:1459–73. https://doi.org/10.1177/0333102420965139 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1177/0333102420965139</ArticleId><ArticleId IdType="pubmed">33146039</ArticleId><ArticleId IdType="pmcid">7684684</ArticleId></ArticleIdList></Reference><Reference><Citation>PREVALE Programma Regionale Valutazione degli Esiti degli Interventi sanitari 2020. http://www.dep.lazio.it/prevale2020/emergenza/tipo10/home_tipo10.php?ind=2&tipo=10&area=1&claeta=1 ). Accessed 14 Sept 2020.</Citation></Reference><Reference><Citation>Lubrano R, Villani A, Berrettini S, Caione P, Chiara A, Costantino A, et al. Point of view of the Italians pediatric scientific societies about the pediatric care during the COVID-19 lockdown: what has changed and future prospects for restarting. Ital J Pediatr. 2020;46:142. https://doi.org/10.1186/s13052-020-00907 .</Citation><ArticleIdList><ArticleId IdType="doi">10.1186/s13052-020-00907</ArticleId><ArticleId IdType="pubmed">33008445</ArticleId><ArticleId IdType="pmcid">7531060</ArticleId></ArticleIdList></Reference><Reference><Citation>Comelli I, Scioscioli F, Cervellin G. Impact of the COVID-19 epidemic on census, organization and activity of a large urban Emergency Department. Acta Biomed. 2020;91:45–9. https://doi.org/10.23750/abm.v91i2.9565 .</Citation><ArticleIdList><ArticleId IdType="doi">10.23750/abm.v91i2.9565</ArticleId><ArticleId IdType="pubmed">32420924</ArticleId><ArticleId IdType="pmcid">7569638</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country><region><li>Latium</li></region><settlement><li>Rome</li></settlement></list><tree><country name="Italie"><region name="Latium"><name sortKey="Raucci, Umberto" sort="Raucci, Umberto" uniqKey="Raucci U" first="Umberto" last="Raucci">Umberto Raucci</name></region><name sortKey="Barbieri, Maria Antonietta" sort="Barbieri, Maria Antonietta" uniqKey="Barbieri M" first="Maria Antonietta" last="Barbieri">Maria Antonietta Barbieri</name><name sortKey="Ciofi Degli Atti, Marta Luisa" sort="Ciofi Degli Atti, Marta Luisa" uniqKey="Ciofi Degli Atti M" first="Marta Luisa" last="Ciofi Degli Atti">Marta Luisa Ciofi Degli Atti</name><name sortKey="Di Lallo, Domenico" sort="Di Lallo, Domenico" uniqKey="Di Lallo D" first="Domenico" last="Di Lallo">Domenico Di Lallo</name><name sortKey="Musolino, Anna Maria" sort="Musolino, Anna Maria" uniqKey="Musolino A" first="Anna Maria" last="Musolino">Anna Maria Musolino</name><name sortKey="Piga, Simone" sort="Piga, Simone" uniqKey="Piga S" first="Simone" last="Piga">Simone Piga</name><name sortKey="Pisani, Mara" sort="Pisani, Mara" uniqKey="Pisani M" first="Mara" last="Pisani">Mara Pisani</name><name sortKey="Raponi, Massimiliano" sort="Raponi, Massimiliano" uniqKey="Raponi M" first="Massimiliano" last="Raponi">Massimiliano Raponi</name><name sortKey="Reale, Antonino" sort="Reale, Antonino" uniqKey="Reale A" first="Antonino" last="Reale">Antonino Reale</name><name sortKey="Rossi, Francesco Paolo" sort="Rossi, Francesco Paolo" uniqKey="Rossi F" first="Francesco Paolo" last="Rossi">Francesco Paolo Rossi</name><name sortKey="Villani, Alberto" sort="Villani, Alberto" uniqKey="Villani A" first="Alberto" last="Villani">Alberto Villani</name><name sortKey="Villani, Alberto" sort="Villani, Alberto" uniqKey="Villani A" first="Alberto" last="Villani">Alberto Villani</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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