Changes in pediatric emergency department visits during the covid-19 pandemic

Abstract

Objective Community mitigation measures were implemented to decrease the spread of SARS-CoV-2. This study aimed to evaluate changes in pediatric emergency department (ED) visits secondary to acute respiratory illnesses (ARI) and trauma before and during the pandemic. We hypothesized that the numbers of ED visits and ARI decreased while the proportion of trauma increased. Patients and Methods A retrospective study from 2018-2020 was performed on children 18 years and younger presenting to the ED either for ARI or trauma at a high-volume comprehensive pediatric hospital between March-May each year. International Classification of Diseases, Tenth Revision, Clinical Modification admission diagnosis codes were used to identify ARI, trauma, and injury mechanisms. Pearson's chi-squared test was used to compare proportions between categorical variables. Results Overall, 6,393 total ED visits occurred in 2020, compared to 11,758 and 12,138 in 2018 and 2019, respectively. In 2020, the total ARI number declined by 58%, and ARI frequency decreased significantly, while the total trauma number declined by 34%, and the proportion of trauma significantly increased. Further, the number and proportion of recreational vehicle accidents increased, while both decreased for all intentional and animal-related trauma. Conclusions The total number of pediatric ED visits dropped precipitously in 2020, but the proportions of trauma increased significantly in 2020, accounting for almost one-third of all ED visits. Injury mechanism varied significantly compared to previous years. Future studies are needed to confirm these findings and evaluate the benefits of community mitigation to decrease ARI and strategies directed to reduce mechanism-specific trauma.