Paediatrics
Did children stop coming to the ER during COVID-19 lockdown?
Open access · cc by · source: Europe PMC
In the first four weeks of Germany's 2020 lockdown, pediatric emergency visits at one hospital fell by almost two-thirds compared with the same weeks in 2019, while no critically ill children appeared to be missed.
Study at a glance
- Design
- Other — Single-centre retrospective before/after comparison of routine ED records for calendar weeks 12-15 of 2020 (lockdown) versus 2019, with January-April of both years for context
- N
- N=5424 · 5,424 ED visits (not unique children) between January 1 and April 19 in 2019 and 2020; diagnoses recorded for 5,206 visits
- Population
- Children and adolescents presenting to the pediatric emergency department of Hannover Medical School, Germany
- Outcome
- Daily ED visit counts, diagnosis categories (communicable vs noncommunicable), hospital admissions, length of stay and PICU admissions
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Key findings
Visits dropped by 63.8% in lockdown weeks compared with 2019, both during the day and overnight. Visits for noncommunicable problems fell by 58% and for suspected or confirmed infections by 70.2%, with respiratory infection presentations down 89%. Only cancer-related presentations increased, and infants under one year made up a larger share of visits. Absolute admissions fell by 38.4%, but the proportion of visits leading to admission almost doubled; length of stay and PICU admissions were similar, and only one child had COVID-19.
Methodology
Researchers analysed routine electronic records of all visits to the pediatric emergency department of a German university hospital. They compared the four weeks after school closures and lockdown began in March 2020 with the same four calendar weeks in 2019, looking at daily visit numbers, age, diagnosis categories grouped from ICD codes, hospital admissions, length of stay and intensive-care admissions.
Limitations
This is a single-centre retrospective comparison of just two four-week periods, so it cannot say why visits fell — parental fear of infection, genuinely less illness from distancing, or 'watch and wait' behaviour. Many records captured only the presenting complaint rather than a confirmed diagnosis, and a large share of diagnoses were unknown or nonspecific. Severe events such as seizures and PICU admissions were so rare that the finding of no missed critical cases is weak, and harms from delayed care might only appear later.
How this study connects
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