key: cord-1033571-jx85yhp3
authors: Rhedin, Samuel Arthur; Ryd Rinder, Malin; Hildenwall, Helena; Herlenius, Eric; Hertting, Olof; Luthander, Joachim; Melén, Erik; Nijman, Ruud; Olsson‐Åkefeldt, Selma; Alfven, Tobias
title: Reduction in paediatric emergency visits during the COVID‐19 pandemic in a region with open preschools and schools
date: 2021-06-22
journal: Acta Paediatr
DOI: 10.1111/apa.15978
sha: c61f9373d28a391f2d9bd2d6a9a43ef53033bd12
doc_id: 1033571
cord_uid: jx85yhp3

Previous studies have reported a reduction in pediatric emergency visits for communicable diseases during the COVID-19 pandemic, which has been related to the use of face masks and school closures. As Sweden imposed less strict restrictions as compared to most countries we aimed to assess the effect of the behavioral changes, however without school closures and general usage of face masks in the society, on the spread of communicable diseases in children. We calculated cumulative incidences of pediatric emergency visits for lower respiratory tract infections (LRTIs), gastroenteritis and as a control diagnosis urinary tract infections (UTIs) comparing 2020 with 2018-2019. Our results suggests that the behavioral changes including improved basal hygiene routines and physical distancing, had a major impact on the disease transmission of LRTIs (cumulative incidence 0.24% in 2020 versus 0.57% during 2018-2019, p<0.001) and gastroenteritis (0.26% versus 0.87%, p<0.001) in children but observed a small increase in UTIs (0.22% versus 0.20%, p=0.01). This raises the question on to what extent some of these recommendations can and should be extended in the post pandemic era.

On 11 March 2020, the novel coronavirus disease COVID-19 was declared a pandemic. As a response, most countries in the world en- However, as a control diagnosis, we assessed the number of visits for UTI, a communicable disease without contact/droplet transmission.

Visits for UTI did not decrease between the studied periods, suggesting that the observed decline in emergency visits was not fully explained by a change in health-seeking behaviour. We did not have data on primary care visits and would hence have missed an increase in visits for LRTI and gastroenteritis in the primary care during the study period. There is also a risk of misclassification bias due to changes in coding routines over the years as our analysis was based on billing codes. Further, it is possible that the introduction of SARS- 

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How to cite this article: Rhedin SA

Reduction in paediatric emergency visits during the COVID-19 pandemic in a region with open preschools and schools