Reduction in Pediatric Emergency Department Admissions during Lockdown: Just Fear of COVID-19?

Objective: Italy was the first European nation to undergo a general lockdown as a means of containing the COVID-19 pandemic. In that period, a significant reduction in pediatric accesses to emergency rooms (ERs) was reported. In this study, we evaluated whether, in addition to the fear of infection, the reduced ER visits were also an indirect indicator of reduced incidence of common seasonal viruses. Methods: Sales data for pediatric formulations of antipyretics and probiotics from 27 pharmacies were evaluated, during March-May 2020, and compared to sales during the same period in 2019. Pediatric accesses in the emergency department (ED) also were evaluated. Results: The median number of antipyretics and probiotics sold per pharmacy was respectively 152 (IQR = 144) and 55 (IQR = 52) in 2019; during the same period of 2020 it was 77.5 (IQR = 60) (p < .001) and 27 (IQR = 44) (p < .05). In the March-May period of 2019, the number of pediatric accesses was 1004, whereas in the same period of 2020 it was 143, a reduction of 85.76% (p < .001). Conclusions: We found a statistically significant reduction in pediatric admissions to the ED during the lockdown, but that this reduction could largely be due to a reduction in seasonal viral disease as an effect of social distancing, mask use, and frequent hand-washing, as mandated by healthcare dispositions.