Impacto del desconfinamiento por la pandemia por COVID-19 sobre el patrón de traumatismos observados en un servicio de urgencias  <span class="so-article-trans-title" dir="auto"> Translated title: Impact of deconfinement due to the COVID-19 pandemic on the trauma pattern observed in an emergency department </span>

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Abstract

Resumen Introducción: después de 42 días de confinamiento decretado por la situación de pandemia mundial por la COVID-19, se permitió la salida de los domicilios a los menores de 14 años. El objetivo de este estudio fue analizar el impacto de este periodo de desconfinamiento en el perfil de accidentes traumatológicos en niños. Material y métodos: se llevó a cabo un estudio observacional retrospectivo de los menores de 16 años atendidos en Urgencias de un hospital terciario por traumatismo entre el 26 de abril de 2020 y el inicio de la desescalada en la Comunidad de Madrid el día 24 de mayo del mismo año. Se comparó el número de traumatismos, las fracturas, el mecanismo de acción y la localización, entre otros, con respecto al mismo periodo del año anterior. Resultados: se observó un aumento significativo en el porcentaje de fracturas respecto al año 2019 (41,9 frente al 11,3%; p <0,001). El porcentaje de accidentes secundarios a vehículos con ruedas (43,9 frente al 6,2%; p <0,001) fue significativamente superior durante 2020, siendo los asociados a bicicleta (35,4%) y patinete (32,2%) los más frecuentes. Conclusiones: durante el periodo de desconfinamiento, se ha producido un notable incremento de los accidentes provocados por vehículos con ruedas en la población infantil, aunque esta observación probablemente esté influida por las medidas organizativas específicas puestas en marcha en Madrid en el periodo de tiempo estudiado.

Translated abstract

Abstract Introduction: after 42 days of lockdown imposed due to the global COVID-19 pandemic, children under 14 years were allowed to leave their homes. The aim of the study was to analyse the impact of the period following the lifting of confinement measures on traumatic injury trends in children. Material and methods: we carried out a retrospective and observational study in children aged less than 16 years that presented with traumatic injuries to the emergency department of a tertiary care hospital between April 26 and the start of the scaling down in the Community of Madrid on May 24. We compared the frequency of traumatic injuries and fractures, the mechanism and site of injury and other variables to those recorded in the same period the year before. Results: there was a significant increase in the proportion of fractures compared to 2019 (41.9 vs. 11.3%; p <0.001). The percentage of accidents related to wheeled vehicles was significantly higher in 2020 (43.9 vs. 6.2%; p <0.001), with these accidents most frequently involving bicycles (35.4%) and scooters (32.2%). Conclusions: in the period following the lockdown, there was a remarkable increase in accidents related to wheeled vehicles in the paediatric population, although this outcome was probably influenced by specific organizational measures implemented in Madrid in the period under study.

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A new coronavirus associated with human respiratory disease in China

Fan Wu, Su Zhao, Bin Yu … (2020)

Emerging infectious diseases, such as severe acute respiratory syndrome (SARS) and Zika virus disease, present a major threat to public health 1–3 . Despite intense research efforts, how, when and where new diseases appear are still a source of considerable uncertainty. A severe respiratory disease was recently reported in Wuhan, Hubei province, China. As of 25 January 2020, at least 1,975 cases had been reported since the first patient was hospitalized on 12 December 2019. Epidemiological investigations have suggested that the outbreak was associated with a seafood market in Wuhan. Here we study a single patient who was a worker at the market and who was admitted to the Central Hospital of Wuhan on 26 December 2019 while experiencing a severe respiratory syndrome that included fever, dizziness and a cough. Metagenomic RNA sequencing 4 of a sample of bronchoalveolar lavage fluid from the patient identified a new RNA virus strain from the family Coronaviridae, which is designated here ‘WH-Human 1’ coronavirus (and has also been referred to as ‘2019-nCoV’). Phylogenetic analysis of the complete viral genome (29,903 nucleotides) revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses (genus Betacoronavirus, subgenus Sarbecovirus) that had previously been found in bats in China 5 . This outbreak highlights the ongoing ability of viral spill-over from animals to cause severe disease in humans.

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Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters

Ginny Sprang, Miriam Silman (2013)

This study investigated the psychosocial responses of children and their parents to pandemic disasters, specifically measuring traumatic stress responses in children and parents with varying disease-containment experiences. A mixed-method approach using survey, focus groups, and interviews produced data from 398 parents. Adult respondents completed the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (PTSD-RI) Parent Version and the PTSD Check List Civilian Version (PCL-C). Disease-containment measures such as quarantine and isolation can be traumatizing to a significant portion of children and parents. Criteria for PTSD was met in 30% of isolated or quarantined children based on parental reports, and 25% of quarantined or isolated parents (based on self-reports). These findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Because pandemic disasters are unique and do not include congregate sites for prolonged support and recovery, they require specific response strategies to ensure the behavioral health needs of children and families. Pandemic planning must address these needs and disease-containment measures. (Disaster Med Public Health Preparedness . 2013;7:105-110)

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Mental health considerations for children quarantined because of COVID-19

Jia Liu, Yanping Bao, Xiaolin Huang … (2020)

To control the transmission of coronavirus disease 2019 (COVID-19), the Chinese Government has implemented strict domestic quarantine policies. As of March 24, 2020, more than 80 000 individuals with COVID-19, and 690 000 individuals who have come into close contact with individuals with COVID-19 have been registered and quarantined, including a large number of children. 1 This quick action has effectively slowed the spread of new cases of infection on both the Chinese mainland and the rest of the world. However, researchers have realised that such measures might have adverse psychological effects on children who are quarantined. For children who are quarantined at home with their parents or relatives, the stress caused by such a sharp change in their environment might be eased to some degree. 2 However, children who are separated from their caregivers require special attention, including children infected with or suspected of being infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), who are quarantined in local hospitals or collective medical observation centres; and children whose caregivers are infected with SARS-CoV-2 or who have died from the disease and are thus under the care of social charity groups. These children might be more susceptible to mental health problems because of their higher risk of infection, and the grief and fear caused by parental loss or separation. Companionship is essential for children's normal psychological development and wellbeing. 3 Separation from caregivers pushes children into a state of crisis and might increase the risk of psychiatric disorders. 4 Sprang and colleagues 5 reported that children who were isolated or quarantined during pandemic diseases were more likely to develop acute stress disorder, adjustment disorder, and grief. 30% of the children who were isolated or quarantined met the clinical criteria for post-traumatic stress disorder. 5 Furthermore, separation from parents or parental loss during childhood also has long-term adverse effects on mental health, including a higher risk of developing mood disorders and psychosis, and death by suicide in adulthood.6, 7 The age of the initial separation is known to be relevant to psychological development. The parent–child separation initiated in the first few years after birth might disrupt the ongoing attachment processes, which might be associated with poorer mental health outcomes. 8 The Chinese Government has implemented a series of strategies to prevent the potential mental health problems that might arise among children who are quarantined during the COVID-19 pandemic. For example, in many Chinese tier 1 cities —typically the largest and wealthiest—like Shanghai, Guangzhou, and Hangzhou, nurses are guaranteed to be available 24 h per day in the children's isolation ward. Nutritionists are invited to give professional guidance for children's diets according to their medical conditions and normal developmental requirements. To reduce fear and other psychological discomfort, children who are quarantined can communicate with their parents via mobile devices at any time. Many citizens from the local community or district volunteers act as temporary mothers to care for recovered children after their discharge, when their caregivers are not available because of infection, quarantine, or death. In response to the notice on improving rescue and protection for children without effective guardianship issued by the Ministry of Civil Affairs, many cities like Zhengzhou opened free psychological counselling hotlines, which were available 24 h per day. 9 Most recently, the National Health Commission of China issued guidelines and listed specific intervention strategies for children who are quarantined in collective medical observation centres. For example, these measures seek to increase children's communication time with their parents; increase children's access to disease information via comic books and videos; guide children to establish a regular activity schedule; provide night lights and small gifts; and provide timely referrals to psychiatrists when children feel mental discomfort, such as worry, anxiety, difficulty sleeping, and loss of appetite. 10 Although great efforts have been made across China, the emerging psychological interventions are unlikely to be provided nationwide because most local support for unaccompanied children focuses only on meeting children's basic daily needs. We propose that paediatric health-care workers should receive formal training to facilitate the early identification of children's mental health problems by learning to discern children's normal and abnormal behaviours, recognise red flags indicating further intervention or referral are needed, and standardise the use of rapid screening tools for mental health. Furthermore, mental health professionals should establish evidence-based guidelines and easy operational strategies to cope with COVID-19 pandemic-related mental health problems in children. We also believe that children's access to mental health services can be improved through collaborative networks that are established nationwide and consist of psychiatrists, psychotherapists, researchers, and community volunteers. Additionally, the post-pandemic surveillance of mental disorders among these children should be considered. Since the global transmission of COVID-19 began, the total number of cases in countries other than China have already exceeded that in China. Following WHO's recommendation, an increasing number of countries have learned from China's experience with regard to quarantine policies. We suggest that the specific response to the mental distress of children who are quarantined should also be considered when designing psychological intervention strategies in response to COVID-19. © 2020 estherpoon/iStock 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Journal

Journal ID (publisher-id): pap

Title: Pediatría Atención Primaria

Abbreviated Title: Rev Pediatr Aten Primaria

Publisher: Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )

ISSN (Print): 1139-7632

Publication date (Print and electronic): September 2021

Volume: 23

Issue: 91

Pages: 247-252

Affiliations

[1] Madrid orgnameHospital Infantil Universitario La Paz España

[2] Madrid orgnameHospital Universitario Infantil La Paz orgdiv1Servicio de Urgencias Pediátricas España

[3] Madrid orgnameHospital Universitario Infantil La Paz orgdiv1Servicio de Pediatría España

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Publisher ID: S1139-76322021000300003 Publisher ID: S1139-7632(21)02309100003

SO-VID: 5eb0b099-95aa-408c-a131-f2ac1c104cf9

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Impacto del desconfinamiento por la pandemia por COVID-19 sobre el patrón de traumatismos observados en un servicio de urgencias Translated title: Impact of deconfinement due to the COVID-19 pandemic on the trauma pattern observed in an emergency department

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Novel Coronavirus Disease COVID-19

Most cited references 18

A new coronavirus associated with human respiratory disease in China

Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters

Mental health considerations for children quarantined because of COVID-19

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