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?:abstract
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Study Objectives: Our syndromic surveillance system of patient chief complaints showed a marked rise in respiratory complaints on March 10th, 2020 as Covid19 arrived in our region Subsequently, pediatric visits to the emergency department (ED) markedly decreased, likely due to recommendations for quarantine and fear of contracting the virus Our goal was to determine the extent of decrease in ED visits for several common pediatric conditions for which parents normally would have sought emergency care Methods: This was a retrospective cohort design The setting was at the EDs of 28 hospitals within 150 miles of New York City Hospitals were teaching or non-teaching and rural, suburban or urban;7 hospitals had separate pediatric EDs Annual ED volumes of pediatric patients were from 3000 to 43,000 Population: Consecutive pediatric patients (age ≤ 21yrs) seen by ED physicians between January 1 and April 30 in 2019 and 2020 Data analysis: We chose to examine the monthly visits for the following using ICD-10 codes: anxiety, appendicitis, asthma, headaches, seizure, and urinary tract infection (UTI) We computed the changes in monthly visits for March and April from 2019 to 2020 We used chi-square to test for statistical significance We set alpha at 0 002, using the Bonferroni correction for multiple comparisons Results: Our database contained 222,302 total pediatric visits Compared to 2019, total visits in January and February 2020 increased by 15% and 4%, respectively, but in March and April they decreased by 36% and 81%, respectively Visits in March and April 2020, compared to the same months in 2019, decreased by 17% and 76%, respectively, for anxiety;by 29% and 34%;for appendicitis;by 40% and 91% for asthma;by 17% and 76% for headache;by 13%, and 60% for seizures;and by 46% and 79% for UTIs All p-values for comparisons were statistically significant, p<0 002, except, in March, for seizures (p=0 25), appendicitis (p=0 007) and headache (p=0 02) Conclusion: We found a marked decrease in ED visits for several common pediatric conditions after COVID-19 arrived in our region We suspect that this decrease was due to recommendations for quarantine during this pandemic as well as fear of exposure to COVID-19 Further studies are needed to determine if this has led to complications due to delay in seeking medical care
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