ECIEN-2020 study: the effect of COVID-19 on admissions for non-COVID-19 diseases

Abstract

Background The pandemic caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) has had great effects on health systems worldwide, not only in relation to coronavirus disease 2019 (COVID-19) cases but also affecting patients with other pathologies. Methods ECIEN-2020 is an observational study conducted in a tertiary referral hospital in Navarra, Spain. It describes the effects of COVID-19 pandemic and the preventive measures adopted, in pediatric admissions for non-COVID-19 diseases. Admissions during March-June 2020 (first wave of the COVID-19 pandemic in Spain) are described and compared with the same quarter in 2019. A sub-analysis was performed delving into epidemiology. Patient characteristics (age, sex, past medical history), disease characteristics (symptoms, duration of symptoms, previous consultation in Primary Care Health Center), and admission characteristics (place and average stay) were analyzed. Results A 33% reduction in the number of pediatric hospital admissions was observed, decreasing from 529 hospitalizations in 2019 to 353 in 2020 (P < 0.001). This highlights a 48% reduction in patients admitted for pulmonary diseases. There were no significant changes in average hospital-stay, percentage of intensive care unit admissions, or in admissions for other reasons. Percentage of patients admitted among those seen in the emergency department rose from 5.1% in 2019 to 10.9% in 2020, whereas the total number of consultations in the emergency department decreased by 68%. Conclusion The pandemic and the measures adopted due to SARS-CoV-2 have significantly decreased pediatric admissions for non-COVID-19 diseases, especially due to a reduction in the hospitalization for respiratory diseases.

Reduction in pediatric growth hormone deficiency and increase in central precocious puberty diagnoses during COVID 19 pandemics

“…This was sharply in contrast with a steady increase in referrals for growth issues that we reported from 2014 to 2018 in a previous study [ 1 ], even though the criteria – according to the Italian Medicines Agency (AIFA) – to perform stimulation tests were the same (i.e., height ≤ − 3 SD; or height ≤ − 2 SD + growth velocity per year ≤ − 1 DS for age and sex evaluated for at least 6 months or a reduction of height of 0.5 SD per year in children > 2 years of age; or height ≤ − 1.5 SD compared to target height and growth velocity per year ≤ − 2 SD or ≤ − 1.5 SD for two consecutive years; or growth velocity per year ≤ − 2 SD or ≤ − 1.5 SD after two consecutive years, even without short stature and after exclusion of other causes of failure to thrive; or malformations/lesions of hypothalamus/pituitary demonstrated at brain MRI) [ 13 ]. Although this is the first study reporting a decrease of referrals for suspected GHD during 2020 lockdowns, our results align with previous reports addressing a delay of hospital care admissions and a reduction of 30–40% in visits during the COVID-19 pandemic [ 9 , 10 ]. A possible explanation for the decrease in tests for suspected GHD is that well-child visits were canceled during the pandemics, removing a chance for family pediatricians to detect short stature and delayed growth.…”

Chest radiograph in hospitalized children with COVID-19. A review of findings and indications

“…Among symptomatic patients, fever (>38 • C) was the most common symptom (37/41), with a mean duration of 3.11 days (SD 3.01). An epidemiological description of all pediatric patients with laboratory confirmed COVID-19 in Navarre, and a more detailed description of the CHN hospitalized patients have been performed [6,7,33]. No mortality, severe pulmonary complications or pulmonary emboli were detected in our study.…”

Pediatric emergency department visits during the COVID-19 pandemic: a large retrospective population-based study

“…A Spanish study reported a reduction in pediatric ED visits during the country’s first pandemic wave, although the percentage of hospitalizations following ED visits had doubled [ 17 ]. This finding is suggestive of a tendency for parents to refrain from presenting their children at the ED during the pandemic, in absence of severe health conditions [ 18 – 21 ].…”