Impact of the Covid-19 pandemic on emergency department visits and hospital admissions in a tertiary hospital in Barcelona, Spain.

BACKGROUND describe the changes observed in admissions and visits to the pediatric emergency department (ED) due to the lockdown during the COVID-19 pandemic. METHODS cross-sectional observational study on pediatric ED and hospital admissions comparing two periods (March 9th-May 9th, 2019 and March 9th-May 9th, 2020). RESULTS 6568 ED visits (53.9% male; mean age 6.5±5.1) were recorded in 2019 and 1133 (55.2% male; mean age 7.3±5.6) in 2020, showing a decrease of 82.7% (81.8 – 83.7%). Severity of patients, procedures and length of stay in ED were significantly higher during the COVID-19 period. Although hospital admissions decreased during the lockdown (-55.1%, p<0.001); 7.9% of ED patients were admitted to the hospital over the study period in 2020 vs 3.0 % in 2019; OR=2.61 (2.03 – 3.35), p<0.001. Hospital admissions related to infectious diseases decreased; OR=0.57 (0.33 – 0.95) and trauma and surgery increased; OR=1.99 (1.16 – 3.41), length of stay remained stable. CONCLUSION the effects of lockdown during the COVID19 pandemic were translated into a significant decrease of ED visits (83%) and hospital admissions (56%), although hospital admission rate increased (OR=2.61). Hygienic measures, managing symptoms at home and fear of coming to the hospital could explain these changes. Telemedicine and public health education interventions are mandatory in times of lockdown, as well as coordination between primary health care centers and hospitals.