The Effect of the COVID-19 Lockdown on the Frequency of Acute Poisoning Presentation to Adult and Pediatric Emergency Departments

Abstract

Background The coronavirus type 2 that causes severe acute respiratory syndrome (SARS-CoV-2) was detected in December 2019 in Wuhan, China. A worldwide emergency response has been initiated because of the fast rise in the number of cases and fatalities during the early stages of the pandemic when vaccinations and efficient medical care were unavailable. Misinformation spread quickly in the early phases of the pandemic, leading to the inappropriate use of medications, chemicals, and traditional remedies for their claimed preventive or therapeutic purposes. Thus, our aim is to identify the impact of the coronavirus disease 2019 (COVID-19) lockdown on the patterns of intoxicated patients presenting to King Abdulaziz Medical City's adult and pediatric emergency departments. Methods A retrospective cohort study was conducted in the adult emergency department at King Abdulaziz Medical City and the pediatric emergency department at King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia. All patients presented with poisoning as a chief complaint between March 23 to June 21 in 2019 (pre-lockdown), 2020 (the lockdown), and 2021 (post-lockdown) were included. Cases of registered poisoning complaints were reviewed and assessed with respect to patient demographics, the causative agent/substance responsible for the poisoning, management of poisoning, and particular outcomes on the approved data collection form by the research team. The data were entered and analyzed by using SPSS v26 (IBM Corp, Armonk, NY). The descriptive statistics are presented as frequency and percentage for the categorical data variables and mean and standard deviation for the numerical data. The data were further analyzed by using cross-tabulation (chi-square test), for the data that are both the predictor and the outcome was categorical. A p-value of < 0.05 was considered significant for all statistical tests. Results Out of 318 patients identified, 164 were adults and 154 were pediatric patients. The mean age of adult and pediatric patients was 33.3±15.5 years and 4±3.6 years, respectively. The majority of patients (115; 70.1%) were males in the adult group and females (90; 58.4%) in the pediatric. The majority of self-harm cases were accidental among both adults and pediatrics, 109 (66.5%) and 144 (93.5%), respectively. The disposition from the emergency department was discharged for 113 (68.7%) adult patients and 134 (87.0%) pediatric patients. The number of cases presented to ER with poisoning cases during the lockdown decreased. This was further tested inferentially, but no significant association was seen among study variables, i.e., p > 0.05. Conclusion The lockdown and pandemic had a significant impact on the rate and patterns of ED visits. The establishment and operation of Drug and Poison Information Centers (DPIC) across the Kingdom, in addition to increasing awareness through campaigns addressing drug and substance safety, is recommended.

Patterns of Toxicities Before, During and After the COVID-19 Pandemic: A Retrospective Study at Poison Control Center - Ain Shams University Hospitals

“…Likewise, the senior age group showed a stable percent through the studied years. Alhussein et al, 2023 recorded similar findings in their study covering the period of the pandemic. For adolescents, there's a noticeable decrease from 12.26% in 2019 to 10.75% in 2020, 11.23% in 2021 and finally 9.48% in 2022.…”

“…Changes were also observed in food productrelated toxicities, which declined in 2020 and 2021, then rebounded to pre-pandemic levels in 2022. This could be attributed to the shift in dietary habits towards home cooking during the pandemic, followed by a return to consuming meals outside of home pre-and post-pandemic (Peden et al, 2008;Alhussein et al, 2023).…”

The trend of poisonings before and after the COVID-19 pandemic

“…The COVID-19 pandemic has also changed the trend of hospitalizations related to poisoning as well as deaths related to poisonings 5 , 6 . For instance, Hadeiy et al found a higher rate of alcohol intoxication and intoxication-related mortality during the COVID-19 pandemic compared to before 7 .…”