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Klin Padiatr 2021; 233(01): 31-36
DOI: 10.1055/a-1263-1467
Original Article

Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main Area

Auswirkung des SARS-CoV2-Lockdowns auf die pädiatrische Versorgung im Rhein-Main-Gebiet
Helena Donath
1   Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University Frankfurt, Germany
,
Stefan Zielen
1   Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University Frankfurt, Germany
,
Boris Wittekindt
2   Department for Children and Adolescents, Division of Neonatology, Goethe University Frankfurt, Germany
,
Thomas Klingebiel
3   Department for Children and Adolescents, Division of Hematology and Oncology, Goethe University Frankfurt, Germany
,
Jürgen Graf
4   University Hospital Frankfurt, Medical Director, Goethe University Frankfurt, Germany
,
Martin Eckrich
5   Group practice Martin Eckrich und Matthias Gründler, Offenbach-Rumpenheim
,
Christian Walter
6   Group practice Christian Walter und Barbara Muehlfeld, Bad Homburg
,
Katharina Blümchen
1   Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe University Frankfurt, Germany
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Correction: Effects of the SARS-CoV2-Lockdown on Pediatric Care in the Rhine-Main AreaKlin Padiatr eFirst
DOI: 10.1055/a-1320-5056

Abstract

Background The effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and lockdown on pediatric diseases and care are not well characterized in Germany.

Patients and Methods To investigate the effects of the lockdown on pediatric medical care in the Rhine-Main area, a survey asking 115 pediatricians and an analysis of the inpatient admissions at the Department for Children and Adolescents Goethe-University, Frankfurt in April 2020 compared to April 2019 was performed.

Results 65/115 (56.5%) pediatricians answered the survey. Pediatricians estimated the reduction of patient consultations in April 2020 vs. 2019 by 40% (median), however, according to their practice administration software, patient visits decreased by 30%. The median number of cases with the diagnosis J21 (acute bronchitis) were significantly less in April 2020 vs. April 2019 (50 vs. 10 cases per pediatrician; p<0.001). Simultaneously, hospital admissions decreased by 43.7% from 402 total cases in April 2019 to 226 cases in April 2020. Hospital admissions due to acute respiratory tract infections or asthma exacerbations as well as neonatal and oncological disorders were significantly reduced compared to the previous year (83.7; 38.1 and 22.1% respectively less to 2019).

Conclusion The lockdown in April 2020 resulted in significantly fewer visits to pediatricians in general practice and hospital admissions, especially for acute respiratory tract infections. The health and economic consequences are discussed.

Zusammenfassung

Hintergrund Die Auswirkungen der Pandemie des severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) und des Lockdowns auf pädiatrische Erkrankungen und die pädiatrische Versorgung sind in Deutschland nicht gut beschrieben.

Patienten und Methoden Um die Auswirkungen des Lockdowns auf die pädiatrische medizinische Versorgung im Rhein-Main-Gebiet zu untersuchen, wurde eine Befragung von 115 Kinderärzten und eine Analyse der stationären Aufnahmen in der Klinik für Kinder- und Jugendmedizin der Goethe-Universitätsklinik Frankfurt im April 2020 im Vergleich zum April 2019 durchgeführt.

Ergebnisse 65/115 (56,5%) Kinderärzte und -ärztinnen beantworteten die Umfrage. Die PädiaterInnen schätzten die Reduktion der Patientenkonsultationen im April 2020 gegenüber 2019 im Median um 40%, allerdings gingen die Patientenbesuche laut ihrer Praxisverwaltungssoftware um 30% zurück. Die mediane Anzahl der Fälle mit der Diagnose J21 (akute Bronchitis) war im April 2020 signifikant niedriger als im April 2019 (50 vs. 10 Fälle pro Pädiater; p<0,001). Gleichzeitig sanken die stationären Aufnahmen um 43,7% von insgesamt 402 Fällen im April 2019 auf 226 Fälle im April 2020. Die stationären Aufnahmen aufgrund von akuten Atemwegsinfektionen oder Asthmaexazerbationen sowie neonatalen und onkologischen Erkrankungen gingen im Vergleich zum Vorjahr deutlich zurück (83,7; 38,1 bzw. 22,1% weniger als 2019).

Schlussfolgerung Der Lockdown im April 2020 führte zu deutlich weniger allgemeinmedizinischen Kinderarztbesuchen und stationären Aufnahmen, insbesondere bei akuten Atemwegsinfektionen. Die gesundheitlichen und wirtschaftlichen Folgen werden diskutiert.

Key words

Lockdown - acute respiratory tract infection - pediatric care - COVID-19 - pandemic - social distancing

Schlüsselwörter

Lockdown - Akuter Infekt der Atemwege - Pädiatrie - COVID-19 - Pandemie - Social Distancing


Publication History

Article published online:
12 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Zhou P, Yang XL, Wang XG. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-273
    Google Scholar
  • 2 Surveillances V. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) China. China CDC Weekly 2020; 2: 113-122
    CrossrefPubMedGoogle Scholar
  • 3 Saglietto A, D‘Ascenzo F, Zoccai GB. et al. COVID-19 in Europe: the Italian lesson. Lancet 2020; 395: 1110-1111
    CrossrefPubMedGoogle Scholar
  • 4 Armocida B, Formenti B, Ussai S. et al. The Italian health system and the COVID-19 challenge. The Lancet. Public Health 2020; 5: e253
    PubMedGoogle Scholar
  • 5 Robert Koch-Institut. Aktueller Lage-/Situationsbericht des RKI zu COVID-19. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020–06–01-de.pdf?__blob=publicationFile (last accessed on 19.Jun.2020)
  • 6 Möckel M, Bachmann U, Behringer W. et al. How emergency departments prepare for virus disease outbreaks like COVID-19. Eur J Emerg Med 2020; 27: 161-162
    CrossrefPubMedGoogle Scholar
  • 7 Wennmann DO, Dlugos CP, Hofschröer A. et al. Umgang mit COVID-19 in der Notaufnahme: Erfahrungsbericht der interdisziplinären Notaufnahme des Universitätsklinikums Münster. Med Klin Intensivmed Notallfmed 2020; 22: 1-8
    PubMedGoogle Scholar
  • 8 World health organization. WHO erklärt COVID-19-Ausbruch zur Pandemie. 12.Mar.2020. https://www.euro.who.int/de/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic (last accessed on 21.Jun.2020)
  • 9 Simonsen L, Clarke MJ, Williamson GD. et al. The impact of influenza epidemics on mortality: introducing a severity index. Am J Public Health 1997; 87: 1944-1950 DOI: 10.2105/ajph.87.12.1944.
    CrossrefPubMedGoogle Scholar
  • 10 Fleming DM. The contribution of influenza to combined acute respiratory infections, hospital admissions, and deaths in winter. Communicable Disease and Public Health 2000; 3: 32-38
    PubMedGoogle Scholar
  • 11 Gillmann B RKI: Zahl der Intensivbetten wird nicht reichen. Handelsblatt. 3. April 2020 www.handelsblatt.com/politik/deutschland/corona-epidemie-rki-zahl-der-intensivbetten-wird-nicht-reichen/25712008.html?ticket=ST-3270452-GX9WyecmTh5JaI6nXhqJ-ap1 (last accessed on 21.Jun.2020)
  • 12 Stang A, Stang M, Jöckel KH. Estimated Use of Intensive Care Beds Due to COVID-19 in Germany Over Time. Dtsch Arztebl Int 2020; 117: 329-335 doi:10.3238/arztebl.2020.0329
    CrossrefPubMedGoogle Scholar
  • 13 Ärzteblatt Corona: Krankenhäuser sollen ab Montag alle planbaren Eingriffe verschieben; 13.Mar.2020. https://www.aerzteblatt.de/ nachrichten/111034/Corona-Krankenhaeuser-sollen-ab-Montag-alleplanbaren-Eingriffe-verschieben (last accessed on 21.Jun.2020)
  • 14 Ramshorn-Zimmer A, Pin M, Hartwig T. et al. Coronapandemie: Rolle der Zentralen Notaufnahme. Dtsch Arztebl 2020; 117: A 1040-A 1044
    PubMedGoogle Scholar
  • 15 Mareiniss DP. The impending storm: COVID-19, pandemics and our overwhelmed emergency departments. Am J Emerg Med 2020; 38 (06) 1293-1294 Epub 2020 Mar 23. PMID: 32253132; PMCID: PMC7102611 DOI: 10.1016/j.ajem.2020.03.033.
    CrossrefPubMedGoogle Scholar
  • 16 Comelli I, Scioscioli F, Cervellin G. Impact of the COVID-19 epidemic on census, organization and activity of a large urban Emergency Department. Acta Biomed 2020; 91: 45-49 Published 2020 May 11 DOI: 10.23750/abm.v91i2.9565.
    CrossrefPubMedGoogle Scholar
  • 17 Ramshorn-Zimmer A, Schröder R, Fakler J. et al. Notaufnahme während der Coronapandemie: Weniger Non-COVID-19-Notfälle. Dtsch Arztebl 2020; 117: A-1201 / B-1016
    PubMedGoogle Scholar
  • 18 Ärzteblatt. Sorge um Patienten mit akutem Bhenaldungsbedarf. 22.Apr.2020 https://www.aerzteblatt.de/nachrichten/112204/Sorge-um-Patienten-mit-akutem-Behandlungsbedarf (last accessed on 19.Jun.2020)
  • 19 Rückkehr zur Regelversorgung: Chronische Krankheiten machen keine Coronapause. Dtsch Arztebl 2020; 117: A-1037/B-A-103877
  • 20 Comelli I, Scioscioli F, Cervellin G. Impact of the COVID-19 epidemic on census, organization and activity of a large urban Emergency Department. Acta Biomed 2020; 91: 45-49 Published 2020 May 11. DOI: 10.23750/abm.v91i2.9565.
    CrossrefPubMedGoogle Scholar
  • 21 Robert Koch Institut. SARS-CoV-2 Steckbrief zur Coronavirus-Krankheit-2019 (COVID-19). 12.Jun.2020. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Steckbrief.html#doc13776792bodyText4 (last accessed on 21.Jun.2020)
  • 22 Dong Y, Mo X, Hu Y. et al. 2020. Epidemiology of COVID-19 Among Children in China. Pediatrics 2020; 145 (06) e20200702 DOI: doi: 10.1542/peds.2020-0702.
    Google Scholar
  • 23 Livingston E, Bucher K. Coronavirus disease 2019 (COVID-19) in Italy. JAMA 2020; 323 (14) 1335 PMID: 32181795 DOI: 10.1001/jama.2020.4344.
    CrossrefPubMedGoogle Scholar
  • 24 Coronavirus Disease 2019 (COVID-19) in Neonates and Children From China: A Review Yuanqiang Yu, Pingyang Chen. Front Pediatr 2020; 8: 287
    CrossrefPubMedGoogle Scholar
  • 25 Ludvigsson J. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109(06): 1088-1095 PMID: 32202343; PMCID: PMC7228328 DOI: 10.1111/apa.15270.
    CrossrefPubMedGoogle Scholar
  • 26 Debatin K, Henneke P, Hoffman GF. et al. Prevalence of COVID-19 in children in Baden-Württemberg (Preliminary study report)
  • 27 Zeit Online. Corona- Virus Karte für Deutschland. 21.Jun.2020. https://www.zeit.de/wissen/gesundheit/coronavirus-echtzeit-karte-deutschland-landkreise-infektionen-ausbreitung (last accessed on 21.Jun.2020)
  • 28 Goerlitz L, Dürrwald R, an der Heiden M. et al. Erste Ergebnisse zum Ver¬lauf der Grippewelle in der Saison 2019/20: Mit 11 Wo¬chen vergleichsweise kürzere Dauer und eine moderate Anzahl an Influenza-bedingten Arztbesuchen. Epid Bull. 2020 16. DOI: 10.25646/6674.2
    Google Scholar
  • 29 Luby SP, Agboatwalla M, Feikin DR. et al. Effect of handwashing on child health: a randomised controlled trial. Lancet 2005; 366: 225-233
    CrossrefPubMedGoogle Scholar
  • 30 Jefferson T, Del Mar CB, Dooley L. et al. Cochrane Review: Interventions for the interruption or reduction of the spread of respiratory viruses. Evid Based Child Health 2008; 3: 951-1013
    CrossrefPubMedGoogle Scholar
  • 31 Masroor S. Collateral damage of COVID-19 pandemic: Delayed medical care. J Card Surg 2020; 35(06): 1345-1347 Epub 2020 May 17. PMID: 32419177; PMCID: PMC7276840 DOI: 10.1111/jocs.14638.
    CrossrefPubMedGoogle Scholar
  • 32 Bouillon-Minois J-B, Schmidt J, Dutheil F. SARS-CoV-2 pandemic and emergency medicine: The worst is yet to come. Am J Emerg Med 2020; S0735-6757(20): 30496-4 Epub ahead of print. PMID: 32593460; PMCID: PMC7286255 DOI: 10.1016/j.ajem.2020.06.014.
    CrossrefPubMedGoogle Scholar
  • 33 Stock L, Brown M, Bradley G. 2020). First Do No Harm With COVID-19: Corona Collateral Damage Syndrome. Western. Journal of Emergency Medicine: Integrating Emergency Care with Population Health. Retrieved from https://escholarship.org/uc/item/7x68t27c (last accessed on 21.Jun.2020)
  • 34 Lazzerini M, Barbi E, Apicella A. et al. Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health 2020; 4: e10-e11 DOI: 10.1016/S2352-4642(20)30108-5.
    Google Scholar
  • 35 Davis-Floyd R, Gutschow K, Schwartz DA. Pregnancy, Birth and the COVID-19 Pandemic in the United States [published online ahead of print, 2020 May 14]. Med Anthropol 2020; 1-15 doi:10.1080/01459740.2020.1761804
    PubMedGoogle Scholar
  • 36 Willan J, King AJ, Djebbari F. et al. Assessing the impact of lockdown: Fresh challenges for the care of haematology patients in the COVID-19 pandemic. Br J Haematol 2020; 189: e224-e227 DOI: 10.1111/bjh.16782.
    CrossrefPubMedGoogle Scholar
  • 37 Bromage DI, Cannata A, Rind IA. et al. The impact of COVID-19 on heart failure hospitalization and management: report from a Heart Failure Unit in London during the peak of the pandemic [published online ahead of print, 2020 Jun 1]. Eur J Heart Fail 2020; 22(06): 978-984 DOI: 10.1002/ejhf.1925.
    CrossrefPubMedGoogle Scholar
  • 38 Bersano A, Kraemer M, Touzé E. et al. Stroke care during the Covid-19 pandemic: Experience from three large European countries [published online ahead of print, 2020 Jun 3]. Eur J Neurol 2020 10.1111/ene.14375 Epub ahead of print. PMID: 32492764; PMCID: PMC7300856. doi:10.1111/ene.14375
  • 39 Hartnett KP, Kite-Powell A, DeVies J. et al. Impact of the COVID-19 Pandemic on Emergency Department Visits - United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 699-704 DOI: 10.15585/mmwr.mm6923e1.
    CrossrefPubMedGoogle Scholar
  • 40 Wong LE, Hawkins JE, Langness S. et al. Where are all the patients? Addressing Covid-19 fear to encourage sick patients to seek emergency care. NEJM Catalyst Innovations in Care Delivery 2020; DOI: 10.1056/CAT.20.0193.
    PubMedGoogle Scholar