Impact of COVID-19 Pandemic on Headache Evaluations in the Pediatric Emergency Department

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, 0.230.42) 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. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

This study evaluated the impact of COVID-19 on evaluations for pediatric emergency department visits due to headaches. The findings showed a significant reduction in the number of evaluations during the pandemic, particularly for secondary headaches.