@article{ref1,
title="Impact of COVID-19 on pediatric emergencies and hospitalizations in Singapore",
journal="BMC pediatrics",
year="2020",
author="Chong, Shu-Ling and Soo, Jenifer Shui Lian and Allen, John Carson Jr and Ganapathy, Sashikumar and Lee, Khai Pin and Tyebally, Arif and Yung, Chee Fu and Thoon, Koh Cheng and Ng, Yong Hong and Oh, Jean Yin and Teoh, Oon Hoe and Mok, Yee Hui and Chan, Yoke Hwee",
volume="20",
number="1",
pages="e562-e562",
abstract="BACKGROUND: Coronavirus disease 2019 (COVID-19) has impacted the provision of health  services in all specialties. We aim to study the impact of COVID-19 on the  utilization of pediatric hospital services including emergency department (ED)  attendances, hospitalizations, diagnostic categories and resource utilization in  Singapore. <br><br>METHODS: We performed a retrospective review of ED attendances and  hospital admissions among children < 18 years old from January 1st to August 8th  2020 in a major pediatric hospital in Singapore. Data were analyzed in the following  time periods: Pre-lockdown (divided by the change in Disease Outbreak Response  System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented  the data using proportions and percentage change in mean counts per day with the  corresponding 95% confidence intervals (CIs). <br><br>RESULTS: We attended to 58,367  children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED  attendance decreased by 331 children/day during lockdown compared to baseline  (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI  - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI  - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate  across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw  226 children with child abuse, with a greater proportion of total attendance seen  post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED  resource utilization, there was a decrease in the overall mean number of procedures  performed per day during the lockdown compared to baseline, driven largely by a  reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7,  p < 0.001). <br><br>CONCLUSIONS: We highlighted a significant decrease in infection-related  presentations likely attributed to the lockdown and showed that the relative  proportion of trauma-related attendances increased. By describing the impact of  COVID-19 on health services, we report important trends that may provide guidance  when planning resources for future pandemics.<p /> <p>Language: en</p>",
language="en",
issn="1471-2431",
doi="10.1186/s12887-020-02469-z",
url="http://dx.doi.org/10.1186/s12887-020-02469-z"
}