Pattern of Emergency Department referral during the COVID-19 outbreak in Italy

Bellan, Mattia; Gavelli, Francesco; Hayden, Eyal; Patrucco, Filippo; Soddu, Daniele; Pedrinelli, Anita; Cittone, Micol Giulia; Rizzi, Eleonora; Casciaro, Giuseppe Francesco; Vassia, Veronica; Landi, Raffaella; Menegatti, Mirta; Gastaldello, Maria Luisa; Beltrame, Michela; Labella, Emanuela; Tonello, Stelvio; Avanzi, Gian Carlo; Pirisi, Mario; Castello, Luigi Mario; Sainaghi, Pier Paolo

doi:10.23736/s0031-0808.20.04000-8

Cited by 46 publications

(24 citation statements)

References 16 publications

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“…This descriptive study analysed pediatric (0-17 years) accesses to all EDs in Lazio Region in 2019 and 2020. We observed a huge reduction of visits in young population, ED pediatric accesses in 2020 decreased of 47% compared to 2019, as reported also by other studies [4][5][6][7][8][9][10][12][13][14][15][16][17]. This study, similarly to others, reported some characteristics of pediatric accesses to ED in 2020 compared to 2019, but, focused, in particular, on the trend analysis, useful to understand the evolution of the behaviour in relation to the pandemic.…”

Section: Discussionsupporting

confidence: 84%

The impact of the SARS COV-2 pandemic on pediatric accesses in ED: A Healthcare Emergency Information System analysis

Mataloni¹,

Colais²,

Pinnarelli³

et al. 2022

PLoS ONE

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Background The Emergency Department (ED) services play a fundamental role in managing the accesses of potential Sars-Cov-2 cases. The aim of this study is to evaluate the impact of the SARS COV-2 pandemic on pediatric accesses in Emergency Department of Lazio Region. Methods The population includes all pediatric accesses (0–17 years) in the ED of Lazio Region during 2019 and 2020. Accesses were characterized by age, week and calendar period. Four periods were defined: pre-lockdown, lockdown, post-lockdown and the second wave. The trend of ED accesses (total or for specific cause) in 2020 (by period and week) were compared to them occurred in 2019. ED visits have been described by absolute frequency and percentage variation. Percentage variation of adult was also reported to compare the trend in adult and young population. The Chi-square test was used to compare characteristics of admissions in 2019 and 2020. Results There is a large decrease of pediatric accesses in 2020 compared to 2019 (-47%), especially for younger age-classes (1–2 years: -52.5% and 3–5 years: -50.5%). Pediatric visits to ED in 2020 decreased following the same trend of adults, but more drastically (-47% vs -30%). ED accesses for suspected COVID-19 pneumonia trend show different characteristics between children and adults: in adults there is an increase in 2020, especially during the 2nd wave period (+321%), in children there is a decrease starting from the lockdown period to the achievement of the lowest level in December 2020 (-98%). Conclusions This descriptive study has identified a decrease of total pediatric accesses in ED in 2020 compared to 2019 and a different trend of accesses by adult and young population especially by cause. The monitoring of paediatric accesses could be a useful tool to analyse the trend of COVID-19 pandemic in Italy and to reprogramming of the healthcare offer according to criteria of clinical and organizational appropriateness.

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Section: Discussionsupporting

confidence: 84%

The impact of the SARS COV-2 pandemic on pediatric accesses in ED: A Healthcare Emergency Information System analysis

Mataloni¹,

Colais²,

Pinnarelli³

et al. 2022

PLoS ONE

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“…The Australian government introduced ‘social distancing’ on 16th March 2020 and significant changes in the public health system were implemented. In emergency departments (ED), international communities recognized a reduction in presentations during the pandemic where reported decreases ranged from 13.0 to 46.3% in ED cases between March and April 2020, compared with the previous year [ 1 , 2 ]. Anecdotally, we noted an unusual increase and pattern at a hospital with delayed presentations of necrotising fasciitis (NF).…”

Section: Introductionmentioning

confidence: 99%

The impact of COVID-19 on delayed presentations of necrotising fasciitis

Nguyen

Diab

Khaicy

et al. 2022

Journal of Surgical Case Reports

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The purpose of this study was to determine the impact of coronavirus disease 2019 (COVID-19) on the delayed presentation of necrotising fasciitis (NF). A retrospective study was conducted of adult patients (≥16 years old) diagnosed with NF at a hospital from 2017 to 2020. A quantitative comparative analysis for the COVID-19 group and control group between 2017 and 2019. Structured interviews were conducted to examine the impact of COVID-19 on patients. There were 6 patients in the COVID-19 group and 10 patients in the control group. The COVID-19 group had a longer mean onset of symptoms till hospital presentation of 4.1 days and a longer mean operative time. The COVID-19 group was more likely to be admitted to intensive care unit. Three patients in the COVID-19 group did not survive compared to survival in the counterparts. Participant responses indicated the COVID-19 pandemic did not prevent them from presenting to ED.

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“…During that period of time, the medical literature reported an increased avoidance of the Emergency Department (ED) for non-COVID-19 illnesses during the pandemic ( 1) , 2) , 3) ). Compared to the same period of past years, many Italian authors have reported a huge reduction of paediatric admissions to ED, ranging from 72% to 92% ( 4 ). Also, during the COVID-19 pandemic in most of the centers elective surgical procedures were cancelled and surgery was limited to urgent surgical or trauma patients.…”

Section: Introductionintroductionmentioning

confidence: 99%