Abstract
Background
The coronavirus type 2 that causes severe acute respiratory syndrome (SARS-CoV-2) was detected in December 2019 in Wuhan, China. A worldwide emergency response has been initiated because of the fast rise in the number of cases and fatalities during the early stages of the pandemic when vaccinations and efficient medical care were unavailable. Misinformation spread quickly in the early phases of the pandemic, leading to the inappropriate use of medications, chemicals, and traditional remedies for their claimed preventive or therapeutic purposes. Thus, our aim is to identify the impact of the coronavirus disease 2019 (COVID-19) lockdown on the patterns of intoxicated patients presenting to King Abdulaziz Medical City's adult and pediatric emergency departments.
Methods
A retrospective cohort study was conducted in the adult emergency department at King Abdulaziz Medical City and the pediatric emergency department at King Abdullah Specialized Children's Hospital in Riyadh, Saudi Arabia. All patients presented with poisoning as a chief complaint between March 23 to June 21 in 2019 (pre-lockdown), 2020 (the lockdown), and 2021 (post-lockdown) were included. Cases of registered poisoning complaints were reviewed and assessed with respect to patient demographics, the causative agent/substance responsible for the poisoning, management of poisoning, and particular outcomes on the approved data collection form by the research team. The data were entered and analyzed by using SPSS v26 (IBM Corp, Armonk, NY). The descriptive statistics are presented as frequency and percentage for the categorical data variables and mean and standard deviation for the numerical data. The data were further analyzed by using cross-tabulation (chi-square test), for the data that are both the predictor and the outcome was categorical. A p-value of < 0.05 was considered significant for all statistical tests.
Results
Out of 318 patients identified, 164 were adults and 154 were pediatric patients. The mean age of adult and pediatric patients was 33.3±15.5 years and 4±3.6 years, respectively. The majority of patients (115; 70.1%) were males in the adult group and females (90; 58.4%) in the pediatric. The majority of self-harm cases were accidental among both adults and pediatrics, 109 (66.5%) and 144 (93.5%), respectively. The disposition from the emergency department was discharged for 113 (68.7%) adult patients and 134 (87.0%) pediatric patients. The number of cases presented to ER with poisoning cases during the lockdown decreased. This was further tested inferentially, but no significant association was seen among study variables, i.e., p > 0.05.
Conclusion
The lockdown and pandemic had a significant impact on the rate and patterns of ED visits. The establishment and operation of Drug and Poison Information Centers (DPIC) across the Kingdom, in addition to increasing awareness through campaigns addressing drug and substance safety, is recommended.