Chen Ying-Ju, Chen Chun-Yu, Lee En-Pei, Huang Wun-Yan, Wu Han-Ping
Department of Pediatric Emergency, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan.
Department of Emergency Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan.
Front Med (Lausanne). 2022 Aug 1;9:941980. doi: 10.3389/fmed.2022.941980. eCollection 2022.
After the coronavirus disease 2019 (COVID-19) pandemic emerged, there has been a substantial decline in emergency department (ED) visits. However, the impact of the pandemic on pediatric ED (PED) visits has not been well discussed. This study aimed to compare the epidemiology and clinical characteristics of PED visits before and after the time of the COVID-19 outbreak.
Data of pediatric patients admitted to the PED between February 2019 and January 2021 were retrospectively collected. All patients were divided into two groups: 1 year before the COVID-19 pandemic (group 1) and 1 year after the COVID-19 outbreak (group 2). Basic demographics, clinical characteristics, triage levels, categories of diagnosis at PED, disposition, and hospitalization rates (wards and intensive care units) were further analyzed and compared between the two groups.
During the study period, 48,146 pediatric patients were enrolled (30,823 in group 1, and 17,323 in group 2). PED visits represented a 43.8% annual decline. The most common diseases in the PED in group 1 were infectious diseases, whereas digestive system diseases were the most common diseases in group 2 (both < 0.001). In group 2, shorter PED observational time, longer hospital stay, and higher admission rates were noted compared to those in group 1 (all < 0.001).
During the COVID-19 pandemic, the proportion of respiratory system diseases and infectious diseases sharply decreased in the PED, whereas the proportion of digestive system diseases relatively increased. The COVID-19 pandemic has impacted the nature of PED visits and we should pay more attention on digestive system diseases and the rates of out-of-hospital cardiac arrest and overall mortality.
2019年冠状病毒病（COVID-19）大流行出现后，急诊科就诊人数大幅下降。然而，大流行对儿科急诊科（PED）就诊的影响尚未得到充分讨论。本研究旨在比较COVID-19疫情爆发前后PED就诊的流行病学和临床特征。
回顾性收集2019年2月至2021年1月期间入住PED的儿科患者数据。所有患者分为两组：COVID-19大流行前1年（第1组）和COVID-19疫情爆发后1年（第2组）。进一步分析并比较两组之间的基本人口统计学、临床特征、分诊级别、PED诊断类别、处置情况以及住院率（病房和重症监护病房）。
在研究期间，共纳入48146名儿科患者（第1组30823名，第2组17323名）。PED就诊人数每年下降43.8%。第1组PED中最常见的疾病是传染病，而第2组中消化系统疾病是最常见的疾病（均P<0.001）。与第1组相比，第2组的PED观察时间更短、住院时间更长且入院率更高（均P<0.001）。
在COVID-19大流行期间，PED中呼吸系统疾病和传染病的比例急剧下降，而消化系统疾病的比例相对增加。COVID-19大流行影响了PED就诊的性质，我们应更加关注消化系统疾病以及院外心脏骤停率和总体死亡率。
