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@article{Nijman:2022:10.1371/journal.pmed.1003974,
author = {Nijman, RG and Honeyford, K and Farrugia, R and Rose, K and Bognar, Z and Buonsenso, D and Da, Dalt L and De, T and Maconochie, IK and Parri, N and Roland, D and Alfven, T and Aupiais, C and Barrett, M and Basmaci, R and Borensztajn, D and Castanhinha, S and Vasilico, C and Durnin, S and Fitzpatrick, P and Fodor, L and Gomez, B and Greber-Platzer, S and Guedj, R and Hartshorn, S and Hey, F and Jankauskaite, L and Kohlfuerst, D and Kolnik, M and Lyttle, MD and Mação, P and Mascarenhas, MI and Messahel, S and Özkan, EA and Puuka, Z and Reis, S and Rybak, A and Ryd, Rinder M and Teksam, O and Turan, C and Thors, VS and Velasco, R and Bressan, S and Moll, HA and Oostenbrink, R and Titomanlio, L and in, association with the REPEM network Research in European Pediatric Emergency Medicine as part of the EPISODES study group},
doi = {10.1371/journal.pmed.1003974},
journal = {PLoS Medicine},
title = {Presentations of children to emergency departments across Europe and the COVID-19 pandemic: A multinational observational study},
url = {http://dx.doi.org/10.1371/journal.pmed.1003974},
volume = {19},
year = {2022}
}

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TY  - JOUR
AB  - BACKGROUND: During the initial phase of the Coronavirus Disease 2019 (COVID-19) pandemic, reduced numbers of acutely ill or injured children presented to emergency departments (EDs). Concerns were raised about the potential for delayed and more severe presentations and an increase in diagnoses such as diabetic ketoacidosis and mental health issues. This multinational observational study aimed to study the number of children presenting to EDs across Europe during the early COVID-19 pandemic and factors influencing this and to investigate changes in severity of illness and diagnoses. METHODS AND FINDINGS: Routine health data were extracted retrospectively from electronic patient records of children aged 18 years and under, presenting to 38 EDs in 16 European countries for the period January 2018 to May 2020, using predefined and standardized data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRRs), using predicted counts for each site as offset to adjust for case-mix differences, were used to compare age groups, diagnoses, and outcomes. Reductions in pediatric ED attendances, hospital admissions, and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (IRR 2.26, 95% CI 1.90 to 2.70, p < 0.001) and in children aged <12 months (12 to <24 months IRR 0.86, 95% CI 0.84 to 0.89; 2 to <5 years IRR 0.80, 95% CI 0.78 to 0.82; 5 to <12 years IRR 0.68, 95% CI 0.67 to 0.70; 12 to 18 years IRR 0.72, 95% CI 0.70 to 0.74; versus age <12 months as reference group, p < 0.001). The lowering of pediatric intensive care admissions was not as great as that of general admissions (IRR 1.30, 95% CI 1.16 to 1.45, p < 0.001). Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1.10, 95% CI 1.08 to 1.12; emergent and very urgent triag
AU  - Nijman,RG
AU  - Honeyford,K
AU  - Farrugia,R
AU  - Rose,K
AU  - Bognar,Z
AU  - Buonsenso,D
AU  - Da,Dalt L
AU  - De,T
AU  - Maconochie,IK
AU  - Parri,N
AU  - Roland,D
AU  - Alfven,T
AU  - Aupiais,C
AU  - Barrett,M
AU  - Basmaci,R
AU  - Borensztajn,D
AU  - Castanhinha,S
AU  - Vasilico,C
AU  - Durnin,S
AU  - Fitzpatrick,P
AU  - Fodor,L
AU  - Gomez,B
AU  - Greber-Platzer,S
AU  - Guedj,R
AU  - Hartshorn,S
AU  - Hey,F
AU  - Jankauskaite,L
AU  - Kohlfuerst,D
AU  - Kolnik,M
AU  - Lyttle,MD
AU  - Mação,P
AU  - Mascarenhas,MI
AU  - Messahel,S
AU  - Özkan,EA
AU  - Puuka,Z
AU  - Reis,S
AU  - Rybak,A
AU  - Ryd,Rinder M
AU  - Teksam,O
AU  - Turan,C
AU  - Thors,VS
AU  - Velasco,R
AU  - Bressan,S
AU  - Moll,HA
AU  - Oostenbrink,R
AU  - Titomanlio,L
AU  - in,association with the REPEM network Research in European Pediatric Emergency Medicine as part of the EPISODES study group
DO  - 10.1371/journal.pmed.1003974
PY  - 2022///
SN  - 1549-1277
TI  - Presentations of children to emergency departments across Europe and the COVID-19 pandemic: A multinational observational study
T2  - PLoS Medicine
UR  - http://dx.doi.org/10.1371/journal.pmed.1003974
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36026507
UR  - http://hdl.handle.net/10044/1/100048
VL  - 19
ER  -

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