Peer-reviewed article
COVID-19 related reduction in pediatric emergency healthcare utilization – a concerning trend
Christian Dopfer, Martin Wetzke, Anna Zychlinsky Scharff, Frank Müller, Frank Dressler et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001During the first four weeks of COVID-19 lockdown in Germany, pediatric emergency department visits dropped by 63.8% compared to the same period in 2019. The reduction affected both communicable and non-communicable diseases. Notably, a higher proportion of infants and cases requiring hospitalization were seen during the pandemic period, suggesting that children with more serious conditions continued to seek care. The study calls for public outreach to encourage parents to seek emergency care despite pandemic concerns.
Key points
- Pediatric emergency department visits decreased from a mean of 26.8 daily visits in 2019 to 9.7 in 2020 (63.8% reduction) in the four weeks after lockdown
- The drop affected both communicable and non-communicable diseases
- Infants under one year represented a larger proportion of visits during the pandemic (23.1% vs 16.6% in 2019)
- Cases requiring hospitalization increased in proportion during the pandemic (26.6% vs 13.9% in 2019)
- Few intensive care admissions and no fatalities occurred during the analyzed periods
Limitations
This is a monocentric study from a single hospital in Germany, limiting generalizability to other settings and countries. The study cannot determine whether the reduction in visits represents delayed or foregone care with potential harms, or the underlying reasons for parental decisions not to seek emergency care.
Abstract
BACKGROUND: The COVID-19 pandemic has disrupted healthcare systems worldwide. In addition to the direct impact of the virus on patient morbidity and mortality, the effect of lockdown strategies on health and healthcare utilization have become apparent. Little is known on the effect of the pandemic on pediatric and adolescent medicine. We examined the impact of the pandemic on pediatric emergency healthcare utilization. METHODS: We conducted a monocentric, retrospective analysis of n = 5,424 pediatric emergency department visits between January 1st and April 19th of 2019 and 2020, and compared healthcare utilization during the pandemic in 2020 to the same period in 2019. RESULTS: In the four weeks after lockdown in Germany began, we observed a massive drop of 63.8% in pediatric emergency healthcare utilization (mean daily visits 26.8 ± SEM 1.5 in 2019 vs. 9.7 ± SEM 1 in 2020, p < 0.005). This drop in cases occurred for both communicable and non-communicable diseases. A larger proportion of patients under one year old (daily mean of 16.6% ±SEM 1.4 in 2019 vs. 23.1% ±SEM 1.7 in 2020, p < 0.01) and of cases requiring hospitalisation (mean of 13.9% ±SEM 1.6 in 2019 vs. 26.6% ±SEM 3.3 in 2020, p < 0.001) occurred during the pandemic. During the analysed time periods, few intensive care admissions and no fatalities occurred. CONCLUSIONS: Our data illustrate a significant decrease in pediatric emergency department visits during the COVID-19 pandemic. Public outreach is needed to encourage parents and guardians to seek medical attention for pediatric emergencies in spite of the pandemic.