J Korean Med Sci.  2022 Dec;37(47):e337. 10.3346/jkms.2022.37.e337.

Comparison of the Clinical Characteristics of Pediatric Poisoning Patients Who Visited Emergency Department Before and During the COVID-19 Pandemic

Affiliations
  • 1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
  • 2Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea

Abstract

Background
We aimed to investigate changes in the clinical characteristics of pediatric poisoning patients who visited the emergency department (ED) before and during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
Poisoning cases below age 18 who visited the ED from January 2018 to December 2021 were retrospectively analysed. The study period was then divided into pre-COVID-19 and COVID-19 pandemic to compare poisoning patterns.
Results
During the study period, 86,153 visits to the pediatric ED had been recorded, with 625 patients being included the final analysis. During the COVID-19 period, the proportion of poisoned patients increased from 0.62% to 0.98%. The average age of the patients was higher in the COVID-19 period, with 53.4% of the cases being intentional (pre-COVID-19, 32.5%; P < 0.001). Moreover, 70.4% of poisoning cases during the COVID-19 period were caused by drugs (pre-COVID-19, 60.6%; P = 0.038). More patients underwent decontamination and laboratory investigation during the COVID-19 period than during the previous period (P= 0.007 and P < 0.001, respectively). The length of ED stay and the proportion of hospitalisation were significantly greater during the COVID-19 period. After analysing accidental poisoning cases, we found that antipyretics/nonsteroidal anti-inflammatory drugs and respiratory drugs were more common in the pre-COVID-19 group, whereas iron/vitamins, cardiovascular drugs and hormones were more common in the COVID-19 group. After analysing intentional poisoning cases, we found that 73.6% and 76.4% of the patients in the pre-COVID-19 and COVID-19 group had a history of psychiatric disease, respectively. Although no difference was observed in the frequency of previous first suicide attempts, 19.0% of the patients in the COVID-19 group attempted suicide more than three times.
Conclusion
During the COVID-19 pandemic, intentional poisoning cases, especially in adolescence, increased and were treated more. Many of the patients with intentional poisoning had a history of mental illness or suicide in the past. Therefore, it seems that policy consideration for mentally vulnerable adolescents during this new pandemic period is necessary.

Keyword

Pediatric; Poisoning; Emergency Department; COVID-19; Suicide; Intentional Poisoning

Figure

  • Fig. 1 Patient distributions according to poisoning purpose over time. The period before COVID-19 is from January 2018 to December 2019. It can be seen in the dotted box from January 2020 to December 2021, during the COVID-19 pandemic. The patient distribution is shown over an annual period categorized as a three-month quarter (Q). When comparing the purpose of poisoning between two groups, the rate of intentional poisoning was higher during the COVID-19 pandemic.COVID-19 = coronavirus disease 2019.


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