How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy.
Identifieur interne : 001B41 ( Main/Exploration ); précédent : 001B40; suivant : 001B42How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy.
Auteurs : Francesco Vierucci [Italie] ; Caterina Bacci [Italie] ; Cristina Mucaria [Italie] ; Francesca Dini [Italie] ; Giovanni Federico [Italie] ; Michela Maielli [Italie] ; Angelina Vaccaro [Italie]Source :
- SN comprehensive clinical medicine [ 2523-8973 ] ; 2020.
Abstract
Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), p < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March - 74.6%, April - 71.6%, May - 58.6%). Nasopharyngeal swabs done in 115 children showed only one case of COVID-19. Even if COVID-19 outbreak more seriously affected Northern Italy, utilization of pediatric emergency services significantly changed also in Central Italy with consequent reduced demand and increased appropriateness.
DOI: 10.1007/s42399-020-00532-5
PubMed: 32984767
PubMed Central: PMC7508675
Affiliations:
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Secondary Care Pediatric Unit in Central Italy.</title><author><name sortKey="Vierucci, Francesco" sort="Vierucci, Francesco" uniqKey="Vierucci F" first="Francesco" last="Vierucci">Francesco Vierucci</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca</wicri:regionArea><wicri:noRegion>55100 Lucca</wicri:noRegion></affiliation></author><author><name sortKey="Bacci, Caterina" sort="Bacci, Caterina" uniqKey="Bacci C" first="Caterina" last="Bacci">Caterina Bacci</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca</wicri:regionArea><wicri:noRegion>55100 Lucca</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>Pediatric Unit, University Hospital of Pisa, Pisa, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Unit, University Hospital of Pisa, Pisa</wicri:regionArea><placeName><settlement type="city">Pise</settlement><region nuts="2">Toscane</region></placeName></affiliation></author><author><name sortKey="Mucaria, Cristina" sort="Mucaria, Cristina" uniqKey="Mucaria C" first="Cristina" last="Mucaria">Cristina Mucaria</name><affiliation wicri:level="3"><nlm:affiliation>Pediatric Unit, University Hospital of Pisa, Pisa, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Unit, University Hospital of Pisa, Pisa</wicri:regionArea><placeName><settlement type="city">Pise</settlement><region nuts="2">Toscane</region></placeName></affiliation></author><author><name sortKey="Dini, Francesca" sort="Dini, Francesca" uniqKey="Dini F" first="Francesca" last="Dini">Francesca Dini</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca</wicri:regionArea><wicri:noRegion>55100 Lucca</wicri:noRegion></affiliation></author><author><name sortKey="Federico, Giovanni" sort="Federico, Giovanni" uniqKey="Federico G" first="Giovanni" last="Federico">Giovanni Federico</name><affiliation wicri:level="4"><nlm:affiliation>University of Pisa, Pisa, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>University of Pisa, Pisa</wicri:regionArea><placeName><settlement type="city">Pise</settlement><region nuts="2">Toscane</region></placeName><orgName type="university">Université de Pise</orgName></affiliation></author><author><name sortKey="Maielli, Michela" sort="Maielli, Michela" uniqKey="Maielli M" first="Michela" last="Maielli">Michela Maielli</name><affiliation wicri:level="1"><nlm:affiliation>San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca</wicri:regionArea><wicri:noRegion>55100 Lucca</wicri:noRegion></affiliation></author><author><name sortKey="Vaccaro, Angelina" sort="Vaccaro, Angelina" uniqKey="Vaccaro A" first="Angelina" last="Vaccaro">Angelina Vaccaro</name><affiliation wicri:level="1"><nlm:affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca</wicri:regionArea><wicri:noRegion>55100 Lucca</wicri:noRegion></affiliation></author></analytic><series><title level="j">SN comprehensive clinical medicine</title><idno type="eISSN">2523-8973</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), <i>p</i> < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March - 74.6%, April - 71.6%, May - 58.6%). Nasopharyngeal swabs done in 115 children showed only one case of COVID-19. Even if COVID-19 outbreak more seriously affected Northern Italy, utilization of pediatric emergency services significantly changed also in Central Italy with consequent reduced demand and increased appropriateness.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32984767</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2523-8973</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Sep</Month><Day>23</Day></PubDate></JournalIssue><Title>SN comprehensive clinical medicine</Title><ISOAbbreviation>SN Compr Clin Med</ISOAbbreviation></Journal><ArticleTitle>How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy.</ArticleTitle><Pagination><MedlinePgn>1-11</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s42399-020-00532-5</ELocationID><Abstract><AbstractText>Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), <i>p</i> < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March - 74.6%, April - 71.6%, May - 58.6%). Nasopharyngeal swabs done in 115 children showed only one case of COVID-19. Even if COVID-19 outbreak more seriously affected Northern Italy, utilization of pediatric emergency services significantly changed also in Central Italy with consequent reduced demand and increased appropriateness.</AbstractText><CopyrightInformation>© Springer Nature Switzerland AG 2020.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Vierucci</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><Identifier Source="ORCID">0000-0002-2192-518X</Identifier><AffiliationInfo><Affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bacci</LastName><ForeName>Caterina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Pediatric Unit, University Hospital of Pisa, Pisa, Italy.</Affiliation><Identifier Source="GRID">grid.144189.1</Identifier><Identifier Source="ISNI">0000 0004 1756 8209</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mucaria</LastName><ForeName>Cristina</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Pediatric Unit, University Hospital of Pisa, Pisa, Italy.</Affiliation><Identifier Source="GRID">grid.144189.1</Identifier><Identifier Source="ISNI">0000 0004 1756 8209</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dini</LastName><ForeName>Francesca</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Federico</LastName><ForeName>Giovanni</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>University of Pisa, Pisa, Italy.</Affiliation><Identifier Source="GRID">grid.5395.a</Identifier><Identifier Source="ISNI">0000 0004 1757 3729</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maielli</LastName><ForeName>Michela</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vaccaro</LastName><ForeName>Angelina</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Pediatric Unit, San Luca Hospital, Via Guglielmo Lippi Francesconi 1, 55100 Lucca, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>SN Compr Clin Med</MedlineTA><NlmUniqueID>101740833</NlmUniqueID><ISSNLinking>2523-8973</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Adolescents</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Children</Keyword><Keyword MajorTopicYN="N">Emergency department</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword></KeywordList><CoiStatement>Conflict of InterestFrancesco Vierucci is a consultant for Abiogen Pharma and received speaker honorarium from Abiogen Pharma. The remaining authors declare that they have no conflict of interest.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>28</Day><Hour>5</Hour><Minute>47</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>9</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32984767</ArticleId><ArticleId IdType="doi">10.1007/s42399-020-00532-5</ArticleId><ArticleId IdType="pii">532</ArticleId><ArticleId IdType="pmc">PMC7508675</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
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