Paediatric domestic accidents during COVID-19 pandemic in Hong Kong

Abstract Background With school closures and social isolation imposed by the COVID-19 pandemic, both children and parents in Hong Kong have been forced to stay at home for extended periods of time. Besides the disease itself growing globally, this pandemic has inflicted many other healthcare problems. This study aims to look at the impact of COVID-19 pandemic on paediatric surgical accidents. Methods A retrospective review of all patients under 18?years of age admitted to a tertiary paediatric surgical unit with accidents was done between January to May 2020 (COVID-19 social isolation period). Comparison was made with cases between January to May 2018 and 2019. Inclusion diagnosis include foreign body ingestion(FBI), scald injury, animal bite, and fall. Demographic data including age and gender, details of injury and treatment, and length of hospitalization were recorded. Statistical analysis was performed by Fisher Exact test and statistical significance was defined as P?≤?0.05. Results A total of 35 patients were admitted during the period 1-5/2020 compared to 28 patients in 1-5/2019 and 16 patients in 1-5/2018. Median age at presentation is 3?years. Diagnosis include FBI, animal bite, scald injury and fall. Thirteen required surgical intervention including OGD (20%), wound debridement (13%), wound suturing (67%). Mean length of hospital stay was 2.89?days. The proportion of domestic accidents in 2020 increased compared with the same period in 2018 and 2019 (P-values = 0.0001, 0.0259). Non-food foreign body ingestions at home during COVID19 increased significantly (P-values = 0.0018, 0.0223). Surgical intervention required for domestic accidents in 2020 also increased (P-values = 0.1223, 0.107). Conclusion The social isolation imposed by the COVID-19 pandemic has caused an increase in paediatric domestic accidents requiring admission to our surgical ward. Governments and healthcare authorities should proactively implement appropriate intervention programs and better plan resources to prevent these domestic accidents during lockdown.

Managing Severe Aortic Stenosis in the COVID-19 Era.

The novel coronavirus disease-2019 (COVID-19) pandemic has created uncertainty in the management of patients with severe aortic stenosis. This population experiences high mortality from delays in treatment of valve disease but is largely overlapping with the population of highest mortality from COVID-19. The authors present strategies for managing patients with severe aortic stenosis in the COVID-19 era. The authors suggest transitions to virtual assessments and consultation, careful pruning and planning of necessary testing, and fewer and shorter hospital admissions. These strategies center on minimizing patient exposure to COVID-19 and expenditure of human and health care resources without significant sacrifice to patient outcomes during this public health emergency. Areas of innovation to improve care during this time include increased use of wearable and remote devices to assess patient performance and vital signs, devices for facile cardiac assessment, and widespread use of clinical protocols for expedient discharge with virtual physical therapy and cardiac rehabilitation options.