Effect of COVID-19 on emergency department visits by paediatric burn patients in Korea: Retrospective Observational Study.

It's been over a year since the outbreak of the coronavirus disease (COVID-19), which is still a global public health challenge. Many countries have implemented social distancing to prevent the risk of infection with COVID-19. As a result, children spend more time at home. Home is where burns among children occur predominantly. We hypothesized that the changes in lifestyle due to the COVID-19 outbreak may have affected paediatric emergency department (PED) visits by children sustaining burn injuries. This study was a long-term multicenter observational study. Paediatric burn patients were defined in accordance with International Classification of Disease, Tenth Edition (ICD-10). We investigated the trend in PED weekly visits by paediatric burn patients before and after the outbreak of COVID-19 and trends in the proportion of visits according to burn severity based on segmented regression analysis. The data were adjusted for seasonality due to seasonal variation in the visits. Over the past three years, the proportion of paediatric burn patients tended to decrease. However, it increased in the fourth week of January 2020, when COVID-19 was first confirmed in Korea. In particular, the proportion of PED visits to paediatric burn patients with severe burns increased after the COVID-19 epidemic. Our study showed increases in the proportion of PED visits among paediatric burn patients due to the spread of COVID-19. Many of these burn accidents mainly occur at home, suggesting the need for parental intervention to prevent the risk of burn injuries among children.

One-year changes in the pediatric emergency department caused by prolonged coronavirus disease 2019 pandemic.

BACKGROUND: With the coronavirus disease 2019 (COVID-19) pandemic lasting for more than a year, it is imperative to identify the associated changes in the use of emergency medical care for efficient operation of the pediatric emergency department (PED). This study was conducted to determine the long-term impact of the COVID-19 pandemic on patterns of PED visits. METHODS: This is a retrospective observational study of visits to the PED of six hospitals, between January 1, 2017, and December 31, 2020. We compared changes in the characteristics of patients before and during the COVID-19 pandemic. RESULTS: A total of 245 022 visits were included in this analysis. After the first case of COVID-19 was reported in Korea, we observed a significant decrease (54.2%) in PED visits compared with the annual average number of visits in the previous 3 years. Since then, the weekly number of PED visits decreased by 11.9 person/week (95% CI: -15.3--8.4, P < 0.001), which included an increase of 0.21% (95% CI: 0.15%-0.26%, P < 0.001) per week in high acuity patients. From 2017 to 2020, the proportion of infectious respiratory diseases by year was 25.9%, 27.0%, 28.6%, and 16.3%, respectively, demonstrating a significant decrease in 2020 (P < 0.001). CONCLUSIONS: During the COVID-19 pandemic, the number of patient visits to PEDs continues to decline, especially among those with infectious diseases. However, the disease severity of patients has gradually increased. There has been a change in the characteristics of visits to PEDs after COVID-19 which will require an appropriate response from a long-term perspective.

Impact of COVID-19 Pandemic on Children Visiting Emergency Department for Mental Illness: A Multicenter Database Analysis from Korea.

We aimed to identify changes in the proportion of pediatric emergency department (PED) visits due to mental illness during the coronavirus disease 2019 (COVID-19) pandemic. This was a retrospective observational study of visits to the PED at six university hospitals from January 2017 to December 2020. We included children aged 5-17 years who were diagnosed with a mental illness. We used segmented regression analysis to identify the change in the proportion of patients with mental illness. A total of 845 patients were included in the analysis. After the first case of COVID-19 was reported in Korea, the number of PED visits significantly decreased by 560.8 patients per week (95% confidence interval (CI): -665.3 to -456.3, p < 0.001). However, the proportion of patients with mental illness increased significantly, by 0.37% per week (95% CI: 0.04% to 0.70%, p = 0.03), at this time point. Subgroup analyses revealed that emotional disorders significantly increased by 0.06% per month (95% CI: 0.02% to 0.09%, p < 0.001) during the pandemic. Our study revealed that an increased proportion of patients with mental illness visited the PED during the COVID-19 pandemic. Specifically, we identified that the proportion of emotional disorders continues to rise during this pandemic.

Impact of COVID-19 pandemic on patients with cardio/cerebrovascular disease who visit the emergency department.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic situation is a state that has had a great impact on the medical system and society. To respond to the pandemic situation, various methods, such as a pre-triage system, are being implemented in the emergency medical field. However, there are insufficient studies on the effects of this pandemic situation on patients visiting the emergency department (ED), especially those with cardio/cerebrovascular diseases (CVD)1 classified as time-dependent emergencies. METHODS: We performed a retrospective analysis of a cohort of patients from April 2020 to December 2020 (April 2020 was when the pre-triage system was established) compared to a parallel comparison patient cohort from 2019. The primary outcome was in-hospital mortality. CVD was defined by the patient's final diagnosis. RESULTS: During the same period, the number of patients who had visited the ED after COVID-19 had decreased to 79.1% of the number of patients who had visited the ED before COVID-19. The overall patient mortality and the mortality in the patients cardiovascular disease had both increased, while the mortality from cerebrovascular disease did not increase. Meanwhile, the ED length of stay had increased in all patients but did not increase in the patients with cardiovascular disease. CONCLUSION: As with prior studies conducted in other regions, in our study, the total number of ED visits were decreased compared to before COVID-19. The overall mortality had increased, particularly in the patients with cardiovascular disease.

Impact of Covid-19 on the Visit of Pediatric Patients with Injuries to the Emergency Department in Korea.

The total number of pediatric emergency department (PED) visitors has decreased worldwide since the coronavirus disease (COVID-19) outbreak. We hypothesized that this might also affect the number of PED visits due to injuries. Therefore, we investigated these changes in PED visits after the COVID-19 outbreak through a long-term multicenter observational study. We assessed the changes in the proportion of injured pediatric patients' weekly visits and the trend in the rate changes since the COVID-19 epidemic began by segmented regression analysis. We also evaluated the weekly change in the distribution of detailed diagnostic codes among pediatric patients with injuries before and after the COVID-19 pandemic. The proportion of injury-related PED visits increased when COVID-19 was first confirmed in Korea. After the COVID-19 epidemic, the proportion of foreign body ingestions and fracture patients among all pediatric patients with injuries increased significantly every week. The changes in the proportion of injured pediatric patients after the COVID-19 outbreak may have been the result of social distancing to prevent the spread of the virus. The risk of pediatric infections decreased but the risk of injury remained. Therefore, parents should take precautions to prevent infectious diseases and be careful to prevent children's injuries at home.