Pediatr Emerg Med J.  2022 Jun;9(1):10-16. 10.22470/pemj.2021.00381.

Effect of coronavirus disease 2019 pandemic on children’s visits to the emergency department

• Kim HM
• Ha SO
• Yang WS
• Park YS
• Kim JH

• KMID: 2531523
• DOI: http://doi.org/10.22470/pemj.2021.00381

Abstract

Purpose
In the coronavirus disease 2019 pandemic, it is essential to supplement the changes in visiting patterns of individual emergency departments (EDs) to determine how to allocate emergency medicine resources. We compared the clinical features of children visiting the ED before and during the pandemic.
Methods
Children younger than 18 years who visited the ED from February 2019 through December 2020, except January 2020, were enrolled, and divided into those who visited before and after January 2020 (the pre-pandemic and pandemic groups, respectively). We compared the 2 groups in terms of the baseline characteristics (age, sex, mode and route of arrival, cause of visit, and time of visit), chief complaint, ED diagnosis, initial acuity and its accuracy, and ED outcomes (length of stay and disposition).
Results
The 31,036 children were categorized into the pre-pandemic (21,027 [67.8%]) and pandemic (10,009 [32.2%]) groups with a 52.4% decrease in the number of visits to the ED in the latter group. This decrease was more prominent in age 2-5 years (from 37.3% to 33.2%; P < 0.001), fever as a chief complaint (from 27.8% to 16.5%), diagnoses related to infection or the respiratory system (from 36.8% to 14.3%) or transfer to the ED (from 8.1% to 6.4%; P < 0.001). In contrast, increases were noted in age 12-17 years (from 14.9% to 17.4%; P < 0.001), injury (from 36.5% to 52.5%; P < 0.001), visits in the evening (from 54.9% to 57.4%; P < 0.001), length of stay longer than 6 hours (from 3.5% to 6.3%; P = 0.033), and low acuity (from 97.8% to 98.2%; P = 0.031).
Conclusion
The pandemic has brought about changes in visiting patterns of the ED. This study may help prepare strategies for the appropriate allocation and deployment of emergency medicine resources in the pandemic era.

Keyword

Child; Coronavirus; Emergency Service, Hospital; Health Resources; Population Characteristics

Figure

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  Fig. 1. Monthly trend of visits to the ED in 2020. Bars indicate the monthly numbers of patients, including adults, with newly diagnosed COVID-19 in Korea. Gray and black lines respectively indicate the monthly numbers of children who visited the ED in 2019 and in 2020 (A). Gray and black lines respectively indicate the monthly numbers of children with disease and with injury who visited the ED (B). COVID-19: coronavirus disease 2019, ED: emergency department.

Reference

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