Collateral damage of the COVID-19 outbreak: expression of concern

Féral‐Pierssens, Anne‐Laure; Claret, Pierre‐Géraud; Chouihed, Tahar

doi:10.1097/mej.0000000000000717

Cited by 79 publications

(83 citation statements)

References 7 publications

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“…This nding is consistent with other reports on the substantial reduction in healthcare utilization in Europe and elsewhere during the current crisis [9,10]. Although a pandemic related reduction in primary healthcare utilization for critically ill patients has been reported [7,8,11], little is known on the changes in pediatric emergency medicine thus far.…”

Section: Discussionsupporting

confidence: 91%

Covid-19 Related Reduction in Paediatric Emergency Healthcare Utilization – A Concerning Trend

Happle

Dopfer

Wetzke

et al. 2020

Preprint

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Background:The COVID-19 pandemic has disrupted healthcare systems worldwide. Besides the direct impact of the virus on morbidity and mortality of patients, the effect of lockdown strategies on health and healthcare utilization become more and more apparent. Little is known on the effect of the pandemic on pediatric healthcare utilization. We examined the impact of the pandemic on pediatric emergency healthcare.Methods: We conducted a monocentric, retrospective analysis of n=5.424 pediatric emergency visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization in the month post lockdown 2020 to the same period in 2019.Results: In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ±SEM 1.5 in 2019 vs. 9.7 ±SEM 1 in 2020, p<0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs 23.1% ±SEM 1.7, p<0.01 in 2020) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p<0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred.Conclusion: Our data illustrate a significant decrease in pediatric emergency room visits during the COVID-19 pandemic. Public outreach is needed to encourage parents to seek medical attention for pediatric emergencies in spite of the pandemic.

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Section: Discussionsupporting

confidence: 91%

Covid-19 Related Reduction in Paediatric Emergency Healthcare Utilization – A Concerning Trend

Happle

Dopfer

Wetzke

et al. 2020

Preprint

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“…The collateral effect of the pandemic on healthcare utilization has been a concern for emergency physicians worldwide [4-10, 12, 13]. For example, a recent study from France revealed a substantial decrease in cases of acute stroke (34%), transitory ischemic attacks (32%), and seizures (36%) presenting to the ED and another study from the USA revealed a 39% decrease in stroke imaging [12,13] However, in our study, the overall reduction in emergency neuroimaging did not result in a decrease in absolute number or proportion of scans with acute findings. This can alleviate, at least to some extent, the fear of "missing out" on severe acute intracranial pathologies requiring urgent medical attention.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on emergency CT head utilization in Ontario—an observational study of tertiary academic hospitals

et al. 2020

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Purpose To determine the impact of the Coronavirus disease-2019 (COVID-19) pandemic on the volume, indications, and results of CT heads performed in the emergency department (ED) at Canadian tertiary academic centers in Ontario. Methods A retrospective review of consecutive CT head examinations ordered through the ED during the early stages of the COVID-19 pandemic in Canada (March 12-April 8, 2020) was performed and compared with that during the pre-COVID-19 period (February 12-March 10, 2020). CT reports were reviewed for the exam indication and the presence of predefined acute findings. A two-sample t test was utilized to compare the cohorts. Daily averages were calculated for all measures to control for the sample size difference between each period. A p value < 0.05 was considered significant. Results Of the total 751 CT head reports, 290 (38.6%) were ordered during the pandemic and 461 (61.4%) were ordered prepandemic. The average daily volume of CT head orders decreased significantly during COVID-19 compared with that during pre-COVID-19 (10.4 scans/day vs 16.5 scans/day; p = 0.001). In terms of indications, the frequency of "non-traumatic ICH" was significantly lower during COVID-19 compared with that during pre-COVID-19 (p = 0.01). Also, there was a significant increase in acute findings on CT during COVID-19 compared with that during pre-COVID-19 (p = 0.001). Conclusion The decreased volume of emergency CT heads performed during the COVID-19 pandemic was associated with a significant increase in the proportion of cases with acute findings. This could be a result of the pandemic's influence on the health-seeking behavior of patients as well as the decision-making process of ordering clinicians.

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“…At the same time, healthcare systems in Europe and elsewhere prepared for an unprecedented health emergency by reallocating resources to care for COVID-19 patients [3][4][5][6]. Public awareness of the pandemic was associated with a vast reduction in healthcare utilization in Italy and other countries [7][8][9][10]. As a result, increased adult and pediatric morbidity and mortality due to delayed healthcare utilization were reported [11,12].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 related reduction in pediatric emergency healthcare utilization – a concerning trend

et al. 2020

View full text Add to dashboard Cite

Background The COVID-19 pandemic has disrupted healthcare systems worldwide. In addition to the direct impact of the virus on patient morbidity and mortality, the effect of lockdown strategies on health and healthcare utilization have become apparent. Little is known on the effect of the pandemic on pediatric and adolescent medicine. We examined the impact of the pandemic on pediatric emergency healthcare utilization. Methods We conducted a monocentric, retrospective analysis of n = 5,424 pediatric emergency department visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization during the pandemic in 2020 to the same period in 2019. Results In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ± SEM 1.5 in 2019 vs. 9.7 ± SEM 1 in 2020, p < 0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs. 23.1% ±SEM 1.7 in 2020, p < 0.01) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p < 0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred. Conclusions Our data illustrate a significant decrease in pediatric emergency department visits during the COVID-19 pandemic. Public outreach is needed to encourage parents and guardians to seek medical attention for pediatric emergencies in spite of the pandemic.

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Collateral damage of the COVID-19 outbreak: expression of concern

Cited by 79 publications

References 7 publications

Covid-19 Related Reduction in Paediatric Emergency Healthcare Utilization – A Concerning Trend

Covid-19 Related Reduction in Paediatric Emergency Healthcare Utilization – A Concerning Trend

Impact of the COVID-19 pandemic on emergency CT head utilization in Ontario—an observational study of tertiary academic hospitals

COVID-19 related reduction in pediatric emergency healthcare utilization – a concerning trend

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