First Do No Harm With COVID-19: Corona Collateral Damage Syndrome

Stock, Lawrence M.; Brown, Mark A.; Bradley, Georgienne

doi:10.5811/westjem.2020.5.48013

Cited by 13 publications

(13 citation statements)

References 2 publications

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Section: Discussionmentioning

confidence: 93%

“…The Corona Collateral Damage Syndrome reported by other authors is symbolic for the lack of acute or emergency medical care for non-COVID-19 emergencies due to the instruction to stay at home during the COVID-19 pandemic [31,33]. This phenomena could explain the reduced number of hospital admissions and patient visits in pediatric practices [33,34]. In particular in the care of time-critical diseases, such as acute coronary syndrome or ischemic stroke, but also cancer or appendicitis underlie considerable collateral damage in the context of delayed emergency care or delayed treatment [33].…”

Section: Discussionmentioning

confidence: 97%

“…This phenomena could explain the reduced number of hospital admissions and patient visits in pediatric practices [33,34]. In particular in the care of time-critical diseases, such as acute coronary syndrome or ischemic stroke, but also cancer or appendicitis underlie considerable collateral damage in the context of delayed emergency care or delayed treatment [33].…”

Section: Discussionmentioning

confidence: 99%

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Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main Area

et al. 2020

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Background The effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and lockdown on pediatric diseases and care are not well characterized in Germany. Patients and Methods To investigate the effects of the lockdown on pediatric medical care in the Rhine-Main area, a survey asking 115 pediatricians and an analysis of the inpatient admissions at the Department for Children and Adolescents Goethe-University, Frankfurt in April 2020 compared to April 2019 was performed. Results 65/115 (56.5%) pediatricians answered the survey. Pediatricians estimated the reduction of patient consultations in April 2020 vs. 2019 by 40% (median), however, according to their practice administration software, patient visits decreased by 30%. The median number of cases with the diagnosis J21 (acute bronchitis) were significantly less in April 2020 vs. April 2019 (50 vs. 10 cases per pediatrician; p<0.001). Simultaneously, hospital admissions decreased by 43.7% from 402 total cases in April 2019 to 226 cases in April 2020. Hospital admissions due to acute respiratory tract infections or asthma exacerbations as well as neonatal and oncological disorders were significantly reduced compared to the previous year (83.7; 38.1 and 22.1% respectively less to 2019). Conclusion The lockdown in April 2020 resulted in significantly fewer visits to pediatricians in general practice and hospital admissions, especially for acute respiratory tract infections. The health and economic consequences are discussed.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main Area

et al. 2020

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“…Parental fear of seeking care during the pandemic is potentially contributing to this change, as well as the wish not to overburden the strained hospital resources with-seemingly-trivial health care problems. This behavior may lead to a severe impairment of overall public health in various fields, which has been termed "Corona Collateral Damage Syndrome" (4).…”

Section: Introductionmentioning

confidence: 99%

Increased Incidence of Perforated Appendicitis in Children During COVID-19 Pandemic in a Bavarian Multi-Center Study

et al. 2021

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Introduction: Since early 2020 the COVID-19 pandemic and statutory preventive reorganization of treatment capacities with cancellation of elective surgery as well as curfew regulations led to vastly decreased utilization of primary health care.Materials and Methods: To assess whether there are negative effects on pediatric acute care in Bavaria during the spring 2020 lockdown a state-wide retrospective multi-center study was performed to analyze the rate of perforated appendicitis during lockdown. Children who have been operated on during the corresponding period in 2018/19 served as control group.Results: Overall, 514 patients (292 boys, 222 girls) were included (2020: 176 patients; 2019: 181 patients; 2018: 157 patients). Median age was 11.2 years. Four hundred thirty-nine patients (85.4%) underwent laparoscopic surgery, 69 (13.4%) open surgery and 1.2% underwent conversion from laparoscopic to open surgery. In 2020 a perforation rate of 27.8% (49/176 patients) was found, in 2018–2019 perforation rate was 20.7% (70/338 patients, p = 0.0359, Cochran-Mantel-Haenszel-Test). Subgroup analysis showed that in younger patients (≤ 11.2 years), in 2020 perforation rate was significantly higher with 37.6% (32/85 patients), while 22.2% (39/176) in 2018/2019 (p = 0.014, Fisher's exact test).In boys perforation rate was significantly higher in 2020 with 35.0% (35/100 patients) compared to 21.4% in 2018–2019 (p = 0.0165, Fisher's exact test).Conclusion: During the period of curfew regulations in Bavaria the rate of perforated appendicitis in childhood increased significantly, especially in younger children and boys. Potentially this has to be attributed to delayed presentation to pediatric surgery care. Because of potential long-term sequelae of perforated appendicitis these adverse effects during curfew have to be taken into account for future political decision making to ensure reasonable patient care and avoid collateral damage in near-future or on-going pandemic situations.

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“…8 , 9 Termed COVID collateral damage syndrome (CCDS), this impact is a result of delay or failure to seek or receive care for acute emergencies for non-COVID-19 conditions. 10 …”

Section: B Ackgroundmentioning

confidence: 99%

Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel

Tripathy

Vijayaraghavan

Panigrahi

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Purpose The impact of disruption to the care of non-coronavirus disease (COVID) patients (COVID collateral damage syndrome-CCDS) is largely unknown in resource-limited settings. We investigated CCDS as perceived by healthcare workers (HCWs) providing acute and critical care services in India. Materials and methods A clinician and nurse codesigned and validated an internet-based survey, which was disseminated to HCWs using a multiple frame sampling technique. Results Responses were received from 468 HCWs (completion rate 84%); at the time of the survey, 48% were working in critical care, 41% aged 30–40 years, and 53% represented public institutions. Respondents perceived a decrease in service utilization and disruption to time-sensitive acute interventions (60.1% and 40.8%, respectively), with fear of infection (score, 63.0; standard deviation (SD), 31.8) and restrictions due to lockdown (61.4; SD 32.5) being cited as the causes of service disruption. Being overwhelmed or lack of protective equipment was perceived to contribute less to CCDS. Insistence on COVID test results X 2 ( p = 0.02) and duty-avoidance ( p < 0.01) was perceived as significant causes for CCDS by HCWs from private hospitals and those in leadership roles, respectively. Conclusions Fear of infection and the effect of lockdown were perceived as important contributors to CCDS resulting in disruption to services and decreased service utilization. Perceptions were influenced by HCWs’ role and hospital organizational structure. How to cite this article Tripathy S, Vijayaraghavan BKT, Panigrahi MK, Shetty AP, Haniffa R, Mishra RC, et al . Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel. Indian J Crit Care Med 2021;25(4):374–381.

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First Do No Harm With COVID-19: Corona Collateral Damage Syndrome

Cited by 13 publications

References 2 publications

Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main Area

Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main Area

Increased Incidence of Perforated Appendicitis in Children During COVID-19 Pandemic in a Bavarian Multi-Center Study

Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel

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