Changes in Children’s Healthcare Visits During COVID-19 Pandemic in Hangzhou, China

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As shown in Figure 1, the daily number of pediatric visits were similar to the historical data before the Chinese New Year (spring festival) at Jan 25, 2020. Coincident with COVID-19 restrictions, the daily number of pediatric visits after Jan 25, 2020 fell to about only one quarter compared with the historical data in 2019 due to the measures such as restriction of travel and social distancing , home quarantine and infection prevention and control in the hospital which suspended some services. Figure 2 shows conditions for which visits were most changed. As shown in Figure 2, A, most decreases in visitations were for other infectious diseases such as respiratory syncytial virus infection (CR=0.07, DVNbefore=4.08, DVNafter=0.08), influenza (CR=0.12, DVNbefore=494.38, DVNafter=15.95), infectious diarrhea (CR=0.12, DVNbefore=9.00, DVNafter=0.29), rotavirus enteritis (CR=0.19, DVNbefore=22.50, DVNafter=1.14) and hand foot mouth disease (CR=0.24, DVNbefore=3.08, DVNafter=0.20).

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Fig. 1

The timeline of daily numbers of pediatric visits, cumulative confirmed cases of COVID-19 in the Zhejiang province and national level of China during pandemic, and daily number of pediatric visits in the same period during 2019.

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Fig. 2

Changes in Children’s healthcare visits during the COVID-19 pandemic in Hangzhou, China. A. Conditions with decreased rate of visits during the pandemic; B. Conditions with increased rate of visits during the pandemic.

Our elective dental visits were suspended after Jan 31, some visits for dental problems also decreased. Visits for the most common pediatric problems, such as acute upper respiratory infection (CR=0.45, DVNbefore=1642.46, DVNafter=193.18) and acute bronchitis (CR=0.39, DVNbefore=610.04, DVNafter=63.24) were inhibited substantially during the pandemic.

As shown in Figure 2, B, there also were conditions for which visits rate increased more than 3-fold during this period. The number of patient visits for problems related to adolescent development, such as adolescent abnormality not otherwise specified (CR=8.48, DVNbefore=1.96, DVNafter=4.38), breast mass (CR=5.24, DVNbefore=1.62, DVNafter=2.24), precocious puberty (CR=4.26, DVNbefore=37.38, DVNafter=41.95), rapid puberty (CR=3.51, DVNbefore=16.79, DVNafter=15.52) unexpectedly rose. Visits for pediatric skin problems, such as atopic dermatitis (CR=7.46, DVNbefore=2.46, DVNafter=4.83), papular urticaria (CR=2.94, DVNbefore=4.67, DVNafter=3.62), eczema (CR=2.75, DVNbefore=58.96, DVNafter=42.67) and otitis externa (CR=4.52, DVNbefore=3.00, DVNafter=3.58) also rose. The number of injuries also rose significantly, especially indoor injuries such as finger injuries (CR=5.30, DVNbefore=1.33, DVNafter=1.86), foreign body entering into or through eye or natural orifice (CR=4.62, DVNbefore=1.92, DVNafter=2.33), tibial fracture (CR=4.04, DVNbefore=1.75, DVNafter=1.86), eyelid laceration (CR=4.03, DVNbefore=4.33, DVNafter=4.61), supracondylar fracture of humerus (CR=4.00, DVNbefore=2.13, DVNafter=2.24). Some cases of epistaxis (CR=4.51, DVNbefore=12.29, DVNafter=14.61) also were due to injuries. After Jan 25, 2020 19 electrical injuries were seen compared with only 6 in the first three months in 2019.

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