Impact of COVID-19 pandemic on accesses for seizures in the pediatric emergency department

Background: Several studies reported a reduced rate of accesses to pediatric emergency department (ED) for seizures during COVID-19 pandemic. The aim of our study is to evaluate the attendance to pediatric ED for seizures, as well as the influence of seizure type and personal history of seizures on the rate of admissions during the pandemic period.

Methods: The number and clinical features of patients admitted to the pediatric ED because of seizures were collected at a single hospital in Milan, Italy, between January 2017 and December 2021. The impact of COVID-19 on the rate of admissions was quantified by using the incidence rate ratio (IRR), comparing the pandemic period (March 2020 to December 2021) to the pre-pandemic (January 2017 to February 2020).

Results: During the study period, 1091 patients with seizures were evaluated, 776 (71.1 %) before the pandemic and 315 (28.9 %) during the pandemic. Mean age at evaluation was 3.9 years (range: 1 month to 17 years). During the pandemic, we found a 30 % decrease in evaluation rates per month (IRR, 0.70; 95 % CI, 0.58-0.84), as well as an increased rate of unprovoked seizures (44.8 %, vs 26.5 %, p < 0.001) and focal seizures (29.5 % vs 13.1 %, p < 0.001).

Conclusions: Our study showed a reduction in the number of emergency evaluations for seizures during the COVID-19 pandemic. The rate of evaluations was influenced by seizure type and previous history of seizures.