Pediatric haedaches epidemiology in emergency department during COVID-19

Background and aims Recent studies have showed that in emergency department (ED) pediatric admissions for headache are increasing in the last years. However Covid-19 pandemic may have changed the use of health services for several reasons. Aim of this study is to analyze the rates of admission for pediatric headaches in ED before and during Covid19 Pandemic. Methods we have collected retrospectively the records of children (range of age 5–14) admitted on ED in 2012, 2019 and 2020. We selected the records including Headache and Headache associated to other symptoms (vomit, fever, dizziness, etc.), collecting further the use of computed tomography (CT) and neurological consultation. Results In 2012, 2019 and 2020 the cephalalgic children admitted to ED were respectively 313/18806 (1.66%), 407/15605 (2.61%) and 234/ 9630 (2.43%). The admission rates for headaches shows highly significant differences between 2012 and biennial 2019/2020. There are no differences in use of CT and neurological consultations. The only difference in access was the initial drop in the first months of lockdown (2020/80% vs 2019/50%). Conclusions Our data support the increase of admission for headache to the pediatric ED in the last ten years. However the Covid-19 pandemic has not increased the admission rate compared to 2019 neither the use of CT or neurological consultations. The fear of using EDs was no changed for headache compared to other pediatric alarm symptoms.