Kostopoulou Eirini, Gkentzi Despoina, Papasotiriou Marios, Fouzas Sotirios, Tagalaki Anastasia, Varvarigou Anastasia, Dimitriou Gabriel
Department of Paediatrics, University General Hospital of Patras, Patras, 26504, Greece.
Department of Internal Medicine, University General Hospital of Patras, Patras, 26504, Greece.
Pediatr Res. 2022 Apr;91(5):1257-1262. doi: 10.1038/s41390-021-01815-w. Epub 2021 Oct 30.
The number of paediatric emergency department (ED) visits and hospital admissions was recorded in a tertiary referral centre during the first year of the COVID-19, March 2020-February 2021, and compared with those of the preceding year.
The number of visits and admissions and the reason of visit and admission were prospectively recorded from 15,087 patients' files.
A substantial decline in the total number of visits and increase in the admission rate were documented during the COVID-19 year compared to the preceding year (10691 vs 4396 patients, 22.59% vs 18.15% (OR: 1.316, CI 95%: 1.208-2.242, p < 0.0001), respectively). Fever and/or respiratory symptoms were the commonest reported symptoms in both periods. Possible explanations include: (i) restricted overall infection transmission due to confinement and self-protective measures, (ii) avoidance of unnecessary hospital visits in the absence of severe symptoms and (iii) reduced or delayed access to medical care due to parental fear of children's exposure to COVID-19.
This study is the first worldwide to investigate the impact of COVID-19 on ED visits and admissions throughout the whole year of the pandemic, and to highlight the need for re-evaluation of future protective strategies to infections, adjustment of health-care systems and parental education so that medical care in a health-care setting is sought in a more appropriate manner.
A significant decline in paediatric ED visits and increase in the admission rate was observed during the first year of COVID-19 in a tertiary referral centre, possibly due to reduced overall infection transmission, limited ED overuse, but also ED underuse due to parental fear of children's exposure to SARS-CoV-2. COVID-19 may serve as an opportunity for societies to re-evaluate future strategies to infections, adjust health-care systems accordingly, and reinforce parents to seek medical care more appropriately. Although the incidence of critical illness in children due to COVID-19 and in general is low, special attention should be devoted to identifying children at risk early.
在2020年3月至2021年2月新冠疫情的第一年，一家三级转诊中心记录了儿科急诊科就诊人数和住院人数，并与上一年的数据进行了比较。
前瞻性地记录了15087份患者档案中的就诊和住院人数以及就诊和住院原因。
与上一年相比，新冠疫情期间就诊总人数大幅下降，住院率上升（分别为10691例对4396例患者，22.59%对18.15%（比值比：1.316，95%置信区间：1.208 - 2.242，p < 0.0001））。发热和/或呼吸道症状是两个时期最常报告的症状。可能的解释包括：（i）由于居家隔离和自我保护措施，总体感染传播受限；（ii）在没有严重症状的情况下避免不必要的医院就诊；（iii）由于家长担心孩子接触新冠病毒，导致获得医疗服务的机会减少或延迟。
本研究是全球首个调查新冠疫情全年对急诊科就诊和住院影响的研究，并强调需要重新评估未来针对感染的防护策略、调整医疗保健系统以及开展家长教育，以便以更恰当的方式在医疗机构寻求医疗服务。
在一家三级转诊中心，新冠疫情第一年观察到儿科急诊科就诊人数显著下降，住院率上升，这可能是由于总体感染传播减少、急诊科过度使用受限，但也可能是由于家长担心孩子接触严重急性呼吸综合征冠状病毒2型导致急诊科使用不足。新冠疫情可促使社会重新评估未来针对感染的策略，相应调整医疗保健系统，并加强家长以更恰当方式寻求医疗服务的意识。尽管儿童因新冠疫情及总体而言患危重病的发生率较低，但应特别关注早期识别高危儿童。
