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Impact of COVID-19 Pandemic on Headache Evaluations in the Pediatric Emergency Department - 08/11/22

Doi : 10.1016/j.pediatrneurol.2022.08.008 
Alberto M. Cappellari, MD a, , Stefania Margiotta, MD b, Gaia Bruschi, MD b, Gianfranco Alicandro, PhD c, d, Massimo Luca Castellazzi, MD e, Alessia Rocchi, MD e, Erica Venturelli, MD b, Giuseppe Bertolozzi, MD e
a Department of Neuroscience and Mental Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy 
b Università degli Studi di Milano, Milan, Italy 
c Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy 
d Cystic Fibrosis Centre, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy 
e Pediatric Emergency Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy 

Communications should be addressed to: Dr. Cappellari; Department of Neuroscience and Mental Health; Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico; Ospedale Maggiore Policlinico, via F. Sforza 28; Milan, Italy.Department of Neuroscience and Mental HealthFondazione IRCCS Cà Granda Ospedale Maggiore PoliclinicoOspedale Maggiore Policlinicovia F. Sforza 28MilanItaly

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Abstract

Background

To evaluate the impact of COVID-19 on evaluations in the pediatric emergency department (ED) because of headache as main symptom.

Methods

Number and clinical features of patients evaluated in the pediatric ED of a single site in Milan, Italy, were collected between January 2017 and January 2022. The impact of COVID-19 on evaluation rates was quantified by using the incidence rate ratio (IRR) and 95% confidence intervals (CI) between the pandemic (March 2020 to January 2022) and the prepandemic period (January 2017 to February 2020).

Results

During the study period, 890 evaluations were registered: 689 over the prepandemic period and 201 over the pandemic period. Mean age at evaluation was 10 years (range: 1 to 17 years). Evaluation rates per month were 18.1 during the prepandemic period and 8.7 during COVID-19 pandemic, with peaks in autumn and winter months and considerable drops in the summer. The IRR was 0.49 (95% CI, 0.40-0.61). The reduction in evaluation rate was higher for secondary headache (IRR, 0.31; 95% CI, 0.23-0.42) when compared with primary headache (IRR, 0.56; 95% CI, 0.40-0.78).

Conclusions

We found a remarkable reduction in the number of evaluations in the pediatric ED for headache during the pandemic period.

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Keywords : SARS-CoV-2, Headache, Children, Emergency department, Neurological disorders, Infectious diseases


Plan


 Conflict of Interest: The authors have no conflicts of interest relevant to this article to disclose.
 Funding/support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
 Contributors' statement: Dr. Cappellari, Dr. Rocchi, Dr. Castellazzi, and Dr. Bertolozzi conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. Dr. Margiotta, Dr. Bruschi, Dr. Venturelli, and Dr. Alicandro designed the data collection instruments, collected data, carried out the initial analyses, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.


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