Implications of the COVID-19 Pandemic for Pediatric Primary Care Practice in Europe

The COVID-19 pandemic has taken a heavy toll on the adult population. In the US, out of 1.4 million diagnosed with COVID-19, 154 children have died. In a large cohort study of 135 794 children tested for COVID- 19, the infection rate was low (4%), many positive children remained asymptomatic, and if signs of illness were present, disease symptoms were typically mild. The case fatality rate in this group was 0.2%. In Europe, early studies showed a low fatality rate of 0.69% in children who tested positive for COVID-19, and 4% developed severe illness. Low mortality and morbidity rates due to COVID-19 in European children during the pandemic were confirmed by the statistical office of the European Union. However, despite the available evidence suggesting that the direct impact of COVID-19 on child and adolescent mortality and morbidity is somehow limited, child services suffered important indirect effects, owing mainly to discontinuities seen throughout Europe by many local health systems strained by the pandemic. The disruptions to care-seeking and preventive interventions in the majority of European countries, including checks for healthy children, vaccination plans, and mental disorders programs, were extensive and concerned the European pediatric societies. The aim of this commentary, jointly authored by the European Confederation of Primary Care Pediatricians (ECPCP) and EPAUNEPSA, is to raise awareness of the indirect consequences caused by the pandemic on pediatric primary care practice in Europe and the risks for child health and well-being.