Abstract
Accidents are the main cause of injury in children, more than half events happen at home. Aims of this study were to assess if SARS-CoV-2 lockdown influence emergency department (ED) visits due to children domestic accident (DAs) and to identify factors associated with hospitalization. This was a multicentre, observational, and retrospective cohort study involving 16 EDs in Italy and enrolling children (3–13 years) receiving a visit in ED during March–June 2019 and March–June 2020. Risk factors for hospitalization were identified by logistic regression models. In total, 8860 ED visits due to domestic accidents in children occurred before (4380) and during (4480) lockdown, with a mean incidence of DA of 5.6% in 2019 and 17.9% in 2020 (p < 0.001) (IRR: 3.16; p < 0.001). The risk of hospitalization was influenced by the type of occurred accident, with fourfold higher for poisoning and twofold lower risk for stab-wound ones. In addition, a higher risk was reported for lockdown period vs 2019 (OR: 1.9; p < 0.001), males (OR: 1.4; p < 0.001), and it increased with age (OR: 1.1; p < 0.001).
Conclusions: The main limitation of this study is the retrospective collection of data, available only for patients who presented at the hospital. This does highlight possible differences in the total number of incidents that truly occurred. In any case, the COVID-19 lockdown had a high impact on the frequency of DAs and on hospitalization. A public health campaign aimed at caregivers would be necessary to minimize possible risks at home.
What is Known: • In Italy, domestic accidents are the second leading cause of paediatric mortality after cancer. • During the first SARS-CoV-2 lockdown in 2020, a sharp decrease in the total number of Emergency Departments visits for all causes was observed, both in children and in adults. |
What is New: • During the first SARS-CoV-2 lockdown in 2020, domestic accidents involving children increased threefold from the previous year. • Higher risk of hospitalization was showed in minors accessing during 2020 vs 2019, in males than in females and it increased with advancing age. Considering the type of injury, a significant higher risk of hospitalization for poisoning was observed. |
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Introduction
Accidents are the main cause of injury and even death or disability in children. It is estimated that ten million children are injured victims [1] and 950,000 dies from accidents each year [2]. Most studies on childhood accidents indicate that more of half events are related to domestic environment, mainly due to general negligence of home safety [1].
In Italy, domestic accidents (DAs) are the second leading cause of paediatric mortality after cancer, accounting for more than 20% of all deaths and representing 75% of the total accidents. Every year, 350,000 children under 14 years of age receive at least one visit in an emergency department (ED) due to this type of injuries, with a predominance of males over females [3]. Even so, only 8% of caregiver living with children are aware of the risk of home injury [4].
From 2020, the scenario was radically changed due to the SARS-CoV-2 pandemic. Several reports have shown that the number of ED visits has decreased worldwide, also in Italy, due to a reduction of infectious diseases and to the caregivers’ fear to risk exposure to SARS-CoV-2 in a health-care setting [5].
On the other hand, from March 2020, all schools and childcare services were closed, with people discouraged from leaving the home, radically changing time spent in it.
The main aim was to investigate if SARS-CoV-2 lockdown affects frequency, severity, and type of ED visits due to DAs occurred in children in a large-scale multicentric study. A secondary aim was to evaluate which factors resulted associated with hospitalization.
Methods
This was a multicentre, observational, and retrospective cohort. The Ethics Committee of University of Siena has confirmed that no ethical approval is required.
Study population
Children aged between 3 and 13 years were included since this age group was the most affected one by the lockdown in terms of the difference in staying at home compared to the previous year.
To obtain a realistic picture of the Italian Country, several paediatric EDs covering most regions were included in the study.
Data collection
DA was defined as “any event occurring inside the house or in immediate surroundings of house that resulted in injury” [6].
The lockdown period from 1st March 2020 to 30th June 2020 was compared with the same period in 2019. Whenever possible, we assessed the total number of visits in ED, among children between 3 and 13 years of age, regardless of the cause.
Demographic data, injury type, and characteristics (including trauma, poisoning, stab wound, burns, and presence of foreign bodies) and patients’ management information were retrieved for all patients with a diagnosis of DA from the ED electronic database of each enrolled hospital. The intentional or abusive trauma were included, too.
Regarding priority code for accessing the ED visits, some hospitals use the new Italian system with 5 colours (including white, green, blue, orange, and red), but the others use the old system with 4 colours (white, green, yellow, red). For this reason, we decided to merge the blue and green codes of the new system into the green code of the old system, and we considered the orange code in the new system as the yellow in the old one. Here are the features of each colour: white, non-urgent problem; green, stable condition with no evolutional risk; yellow, risk of impairment of vital functions; red, interruption or impairment of one or more vital functions.
Statistical analysis
Categorical variables were described as frequency with percentages, and continuous variables were described as mean with standard deviation and range (min–max).
Differences in continuous variables were assessed by Student’s t test or corresponding non-parametric Mann–Whitney U test based on data distribution. Any relationship between discrete categorical data was explored by the chi-square test, or Fisher’s exact test, as appropriate.
Univariate and subsequent multivariate logistic regression models (adjusted for age and sex of the patients) were fitted to search for risk factors associated with hospitalization. The multivariate model included as independent predictor variables only factors with a p value < 0.10 at univariate analysis. Statistical significance was set at 0.05.
Results
Overall, 8860 visits for DA were recorded in 16 EDs, of which 4380 in 2019 and 4480 in 2020. Considering total ED visits, among children between 3 and 13 years of age, for all causes, 69,160 visits occurred in 2019 and 23,556 in 2020 (data available for 12 enrolled EDs), with a mean incidence of DA of 5.6% (CI 95%: 5.4–5.8) in 2019 and 17.9% (CI 95%: 17.3–18.4) in 2020 (p < 0.001) and an incidence rate ratio (IRR) of 3.16 (3.02–3.30; p < 0.01) (Appendix — Table 4).
Most of patients were males (56% in both periods), with a mean age of 7.1 years (SD ± 3.18) in 2019 and 6.9 years (SD ± 3.02) in 2020.
Patients with a high priority code (yellow/red) for ED visits were significantly reduced from 13% in 2019 to 10% in 2020 (p = 0.001), but the number of patients arriving to the ED with the ambulance increased (from 6.6% in 2019 to 9.7% in 2020; p < 0.001).
Other demographics, clinical characteristics, and hospital access info of the sample are presented in Table 1.
No child enrolled in 2020 tested positive for SARS-CoV-2.
Considering the mechanism of injury, only stab wound registered a significant change in frequency in 2020, with an increment from 16.4% in 2019 to 19.2% in 2020 (p = 0.001). In general, trauma/falls were the most frequent, reported in 82.5% of cases in 2019 and 81.1% in 2020, followed by stab wound and foreign object introduction (8.0% in 2019 and 7.6% in 2020) (Fig. 1).
We assessed the age difference based on the presence/absence of occurrence of a certain mechanism of injury, and we observed an older age of patients having a suspected non-accidental trauma (presence vs absent 8.5 ± 3.68 vs 7.0 ± 3.10, p < 0.001) or a trauma/fall (presence vs absent 7.1 ± 3.12 vs 6.6 ± 3.02, p < 0.001). On the contrary, younger patients have received an ED visit for stab wound (presence vs absent 6.4 ± 2.78 vs 7.1 ± 3.16, p < 0.001), for a foreign object introduction (presence vs absent 6.3 ± 2.78 vs 7.0 ± 3.12, p < 0.001) and for poisoning (presence vs absent: 6.1 ± 3.34 vs 7.0 ± 3.10, p < 0.001). No difference was observed for burn accidents (p = 0.53) (Appendix — Table 5 and Fig. 2).
Patients in 2020 required more frequently diagnostic tests, especially limbs X-ray (from 30.9% in 2019 to 38.5% in 2020, p < 0.001), blood sampling (from 4.6% in 2019 to 5.6% in 2020, p = 0.026), and surgical therapy (from 13.2% in 2019 to 20.2% in 2020, p < 0.001). In the same way, the visits requiring a specialist consultation in ED increased (from 48.2% in 2019 to 57.1% in 2020, p < 0.001), whereas prescriptions of medical therapy decreased (from 64.1% in 2019 to 61.6% in 2020, p = 0.012) (Appendix — Table 6).
When evaluating the outcomes, we observed a sharp increase in the number of hospitalization (from 4.7% in 2019 to 8.4% in 2020, p < 0.001) and in the estimated recovery period (from 5 days in 2019 to 7 days in 2020, p < 0.001) (Table 2).
The risk of ED admission with a severe priority code (yellow/red) was higher when the accident occurred without the presence of a parent or caregiver (OR: 1.87, 95% CI: 1.48–2.36; p < 0.001).
Table 3 reports factors associated to hospitalization. Higher risk of hospitalization was showed in patients accessing during 2020 vs 2019 (OR: 1.86, 95% CI: 1.55–2.24; p < 0.001), in older patients (OR: 1.07, 95% CI: 1.04–1.10; p < 0.001) and in males compared to females (OR: 1.37; 95% CI: 1.14–1.65; p = 0.001). Patients arriving to the ED with the ambulance had a higher risk of hospitalization compared to patients who reached the hospital independently (OR: 6.49, 95% CI: 5.29–7.96; p < 0.001). Considering the type of injury, we observed a significant higher risk of hospitalization for poisoning (vs other reasons, OR: 3.52; 95% CI: 1.96–6.31; p < 0.001) and lower risk in case of stab wound (vs other reasons, OR: 0.51; 95% CI: 0.37–0.71; p < 0.001). In univariate analysis, a relevant effect of suspected non-accidental trauma on hospitalization was found (OR 2.05, 95% CI: 1.02–4.15; p = 0.045), however, not confirmed in the subsequent multivariate analysis.
Discussion
To the best of our knowledge, this is the first Italian multicentre study that aims to understand the impact of SARS-CoV-2 lockdown to the ED visits for DA in children.
Despite the sharp decrease in the number of ED visits for all causes observed in children during the lockdown period, confirming other Italian literature data [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21], the number of visits for DAs remained stable, highlighting higher odds of paediatric visits for DA in 2020 than 2019. This increase of risk of DAs during lockdown period confirms data observed in the previous monocentric/regional studies conducted in Italy [15,16,17, 19, 20, 22, 23]. It might be explained not only with the growing number of hours spent at home but probably also with the negative psychological effects of COVID-19 home confinement both in children and in parents/caregivers [23]. If lockdown on the one hand concurred to the reduction of total ED visits for the decrease of infectious diseases in children, on the other, it contributed to the deterioration of psychological wellbeing due to home confinement, the lack of personal space, physical activity, and social interaction, not only for children but also in parents. All these negative effects could bring to a reduction of child supervision with an increase of accidents [23].
No difference in the frequency of suspected non-accidental trauma was found between two observation periods; in any case, this kind of data could be underestimated because cases collected in ED databases do not allow to correctly estimate whether children were actual victims of abuse [24].
Regarding the severity of injuries, during 2020, we observed a reduction in the white code visits compared to 2019, indicating an avoidance of unnecessary visits, probably due to the fear about contracting the SARS-CoV-2 in hospitals. During 2020, the number of visits with green code increased compared to 2019, probably due to COVID-19 prevention measures with reduction of outpatient activities in most of paediatric hospitals.
A recent study has shown that the increase of hospitalization might be explained by change of hospital protocol for injury treatment at ED. If before SARS-CoV-2 pandemic many operative procedures could be performed directly at the ED, during lockdown, patients were hospitalized to receive the same procedures [23]. However, this change in patient management was not confirmed by all centres participating in this study.
Regarding factors increasing odds of being hospitalized, poisoning represented the major risk, although it is responsible for a very small part of all ED admissions, and principal causes were drugs and cleaning products. In fact, in younger children, the ingestion of drugs could be due to the imitation of adult behaviours, while for cleaning products, particular attention should be paid to colourful ones and easy-to-open containers [25].
Conclusions
The present study has a main limitation which should be mentioned. Data were collected retrospectively and were only available for patients who presented at the hospital. This finding shows possible differences in ED accesses between the two observation periods, but not in the total number of incidents that truly occurred. Certainly, there may be an underestimation in the number of milder incidents, which, during the lockdown, may have been handled at home and not in hospital. In addition, we have to consider that this is a retrospective study and, as such, we could not retrieve missing data. The analysis of factors associated with hospitalization was limited to variables collected in the medical records. It would be interesting to investigate the cases of suspected non-accidental incidents, an analysis that we will reserve for a new project.
In any case, our study confirms, at national level, that SARS-CoV-2 lockdown had a high impact on paediatric ED visits for DA, and on hospitalization too. In fact, although the home confinement was a successful strategy to prevent the diffusion of SARS-CoV-2, it seems to have a negative impact on the risk of DA.
Regarding risk of injuries at home and, in particular, poisoning, a public health campaign aimed at caregivers would be necessary to minimize possible risks at home.
Data availability
The data that support the findings of this study are available from the corresponding author, DB, upon reasonable request.
Change history
08 July 2023
A Correction to this paper has been published: https://doi.org/10.1007/s00431-023-05060-7
Abbreviations
- DA:
-
Domestic accident
- ED:
-
Emergency department
- IRR:
-
Incidence rate ratio
References
da Silva MF, da Fontinele DR, de Oliveira AVS et al (2017) Determining factors of domestic accidents in early childhood. Journal of Human Growth and Development 27:10–18. https://doi.org/10.7322/jhgd.127643
EpiCentro Oms e Unicef: la prevenzione degli infortuni e degli incidenti nei bambini. https://www.epicentro.iss.it/incidenti/infanziaOms08. Accessed 17 Jan 2023
La sorveglianza Siniaca. In: ISS. https://iss.it/siniaca-la-sorveglianza-siniaca. Accessed 17 Jan 2023
EpiCentro Sicurezza domestica dati sorveglianza Passi. https://www.epicentro.iss.it/passi/dati/SicurezzaDomestica. Accessed 17 Jan 2023
Kruizinga MD, Peeters D, van Veen M et al (2021) The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature. Eur J Pediatr 180:2271–2279. https://doi.org/10.1007/s00431-021-04015-0
Tsoumakas K, Dousis E, Mavridi F et al (2009) Parent’s adherence to children’s home-accident preventive measures. Int Nurs Rev 56:369–374. https://doi.org/10.1111/j.1466-7657.2009.00720.x
Cella A, Marchetti F, Iughetti L et al (2020) Italian COVID-19 epidemic: effects on paediatric emergency attendance-a survey in the Emilia Romagna region. BMJ Paediatr Open 4:e000742. https://doi.org/10.1136/bmjpo-2020-000742
Ciacchini B, Tonioli F, Marciano C et al (2020) Reluctance to seek pediatric care during the COVID-19 pandemic and the risks of delayed diagnosis. Ital J Pediatr 46:87. https://doi.org/10.1186/s13052-020-00849-w
Cozzi G, Zanchi C, Giangreco M et al (2020) The impact of the COVID-19 lockdown in Italy on a paediatric emergency setting. Acta Paediatr 109:2157–2159. https://doi.org/10.1111/apa.15454
Lazzerini M, Barbi E, Apicella A et al (2020) Delayed access or provision of care in Italy resulting from fear of COVID-19. Lancet Child Adolesc Health 4:e10–e11. https://doi.org/10.1016/S2352-4642(20)30108-5
Matera L, Nenna R, Rizzo V et al (2020) SARS-CoV-2 pandemic impact on pediatric emergency rooms: a multicenter study. Int J Environ Res Public Health 17:8753. https://doi.org/10.3390/ijerph17238753
Valitutti F, Zenzeri L, Mauro A et al (2020) Effect of population lockdown on pediatric emergency room demands in the era of COVID-19. Front Pediatr 8:521. https://doi.org/10.3389/fped.2020.00521
Vierucci F, Bacci C, Mucaria C et al (2020) How COVID-19 pandemic changed children and adolescents use of the emergency department: the experience of a secondary care pediatric unit in Central Italy. SN Compr Clin Med 2:1959–1969. https://doi.org/10.1007/s42399-020-00532-5
Morello F, Bima P, Ferreri E et al (2021) After the first wave and beyond lockdown: long-lasting changes in emergency department visit number, characteristics, diagnoses, and hospital admissions. Intern Emerg Med 16:1683–1690. https://doi.org/10.1007/s11739-021-02667-2
Iozzi L, Brambilla I, Foiadelli T et al (2020) Paediatric emergency department visits fell by more than 70% during the COVID-19 lockdown in Northern Italy. Acta Paediatr 109:2137–2138. https://doi.org/10.1111/apa.15458
Mataloni F, Colais P, Pinnarelli L et al (2022) The impact of the SARS COV-2 pandemic on pediatric accesses in ED: a healthcare emergency information system analysis. PLoS One 17:e0272569. https://doi.org/10.1371/journal.pone.0272569
Raffaldi I, Castagno E, Fumi I et al (2021) Pediatric admissions to emergency departments of North-Western Italy during COVID-19 pandemic: a retrospective observational study. Lancet Reg Health Eur 5:100081. https://doi.org/10.1016/j.lanepe.2021.100081
Clavenna A, Nardelli S, Sala D et al (2020) Impact of COVID-19 on the pattern of access to a pediatric emergency department in the Lombardy Region, Italy. Pediatr Emerg Care 36:e597–e598. https://doi.org/10.1097/PEC.0000000000002232
Liguoro I, Pilotto C, Vergine M et al (2021) The impact of COVID-19 on a tertiary care pediatric emergency department. Eur J Pediatr 180:1497–1504. https://doi.org/10.1007/s00431-020-03909-9
Raucci U, Musolino AM, Di Lallo D et al (2021) Impact of the COVID-19 pandemic on the emergency department of a tertiary children’s hospital. Ital J Pediatr 47:21. https://doi.org/10.1186/s13052-021-00976-y
Masetti R, Corsini I, Leardini D et al (2020) Presentations to the emergency department in Bologna, Italy, during COVID-19 outbreak. BMJ Paediatr Open 4:e000748. https://doi.org/10.1136/bmjpo-2020-000748
Bressan S, Gallo E, Tirelli F et al (2021) Lockdown: more domestic accidents than COVID-19 in children. Arch Dis Child 106:e3. https://doi.org/10.1136/archdischild-2020-319547
Ferro V, Nacca R, Pisani M et al (2022) Children at risk of domestic accidents when are locked up at home: the other side of COVID-19 outbreak lockdown. Ital J Pediatr 48:129. https://doi.org/10.1186/s13052-022-01318-2
Castagnino M, Paglino A, Berardi C et al (2020) Recording risk factors of physical abuse in children younger than 36 months with bone fractures: a 12-years retrospective study in an Italian general hospital emergency room. Front Ped 8:183. https://doi.org/10.3389/fped.2020.00183
Soave PM, Curatola A, Ferretti S et al (2022) Acute poisoning in children admitted to pediatric emergency department: a five-years retrospective analysis. Acta Biomed 93:e2022004. https://doi.org/10.23750/abm.v93i1.11602
Funding
Open access funding provided by Università degli Studi di Siena within the CRUI-CARE Agreement.
Author information
Authors and Affiliations
Consortia
Contributions
Daiana Bezzini and Irene Schiavetti designed the study and directed the project. Marcello Lanari contributed to the implementation of the study design. Patients’ data collection was performed by Alessandro Amaddeo, Melodie O. Aricò, Emanuele Castagno, Gabriella Cherchi, Giulia Giacomini, Giulia Graziani, Salvatore Grosso, Marcello Lanari, Ilaria Liguoro, Francesca Lombardi, Sergio Manieri, Laura Moschettini, Francesca Parisi, Antonino Reale, Giulia Romanisio, and Davide Silvagni. Data management and analysis were performed by Irene Schiavetti. The first draft of the manuscript was written by Daiana Bezzini and Irene Schiavetti and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Keep Me Safe study group | |
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Alberto Gaiero | Pediatric and Neonatology Unit, Asl 2 Ospedale San Paolo, Savona, Italy |
Alessandra Iacono | Department of Paediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy |
Alessandro Amaddeo | Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste, Italy |
Alessandro Canetto | Pediatric Emergency Medicine, Emergency Department, Ospedale San Michele, ARNAS “G. Brotzu”, Cagliari, Italy |
Alice Fachin | Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy |
Angela Demarco | Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy |
Annalisa Lo Sasso | Department of Medicine (DAME), Division of Pediatrics, University of Udine, Udine, Italy |
Annalisa Rossetti | Clinical Paediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy |
Antonino Reale | Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy |
Arianna Dagri | Department of Medicine (DAME), Division of Pediatrics, University of Udine, Udine, Italy |
Carmela G. Raffaele | Pediatric Department, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy |
Chiara Ghizzi | Pediatric Department, Maggiore Hospital Carlo Alberto Pizzardi, Bologna AUSL, Bologna, Italy |
Claudia Bondone | Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy |
Daiana Bezzini | Department of Life Sciences, University of Siena, Siena, Italy |
Daniele Zama | Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy |
Davide Silvagni | Department of Pediatric Emergency, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy |
Elisa Pala | Specialty School of Pediatrics, University of Cagliari, Cagliari, Italy |
Elisabetta Pangallo | Pediatric department, University of Milano Bicocca, Milano, Italy |
Emanuele Castagno | Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy |
Enrico Valerio | Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy |
Enrico Valletta | Pediatric Department, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy |
Federico Marchetti | Department of Paediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy |
Francesca Lombardi | Pediatric Department, Maggiore Hospital Carlo Alberto Pizzardi, Bologna AUSL, Bologna, Italy |
Francesca Nicolardi | Department of Medicine, Surgery and Health Science, University of Trieste, Trieste, Italy |
Francesca Parisi | Pediatric Clinic, Department of Medicine and Surgery, University of Perugia, Perugia, Italy |
Francesco Medici | Pediatric department, University of Milano Bicocca, Milano, Italy |
Francesco Silenzi | IRCCS Meyer University Children’s Hospital, Florence, Italy |
Gabriella Cherchi | Pediatric Emergency Medicine, Emergency Department, Ospedale San Michele, ARNAS “G. Brotzu”, Cagliari, Italy |
Giulia Ceccarini | Pediatric Clinic, Department of Medicine and Surgery, University of Perugia, Perugia, Italy |
Giulia Giacomini | IRCCS Meyer University Children's Hospital, Florence, Italy |
Giulia Graziani | Department of Paediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy |
Giulia Romanisio | Pediatric and Neonatology Unit, asl2 Ospedale San Paolo Savona, Savona, Italy |
Ilaria Corsini | Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy |
Ilaria Liguoro | Department of Medicine (DAME), Division of Pediatrics, University of Udine, Udine, Italy & Pediatric Clinic, “Santa Maria della Misericordia” University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy |
Irene Frigo | Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy |
Irene Raffaldi | Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy |
Irene Schiavetti | Department of Health Sciences, University of Genoa, Genoa, Italy |
Laura Andreozzi | Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy |
Laura Moschettini | Pediatric Department, University of Milano Bicocca, Milano, Italy |
Laura Penta | Pediatric Clinic, Department of Medicine and Surgery, University of Perugia, Perugia, Italy |
Luca Bianchini | Specialty School of Pediatrics, University of Cagliari, Cagliari, Italy |
Luciana Romaniello | Department of Pediatrics, San Carlo Hospital, Potenza, Italy |
Manuel Murciano | Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy |
Manuela Pagano | Department of Pediatric Emergency, Regina Margherita Children’s Hospital - A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy |
Marcello Lanari | Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy |
Maria Chiara Supino | Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy |
Maria Pia Mirauda | Department of Pediatrics, San Carlo Hospital, Potenza, Italy |
Martina Scilipoti | Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy |
Matteo Calvi | Pediadric Emergency Department, ASST Papa Giovanni XXIII, Bergamo, Italy |
Melodie O. Aricò | Pediatric Department, G.B. Morgagni - L. Pierantoni Hospital, Forlì, Italy |
Monia Gennari | Pediatric Emergency Unit, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy |
Nicoletta Della Vecchia | Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy |
Paolo Biban | Department of Pediatric Emergency, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy |
Paolo Tarlazzi | Public health administration, Santa Maria delle Croci Hospital, Ravenna, Italy |
Raffaele Pecoraro | Department of Pediatrics, San Carlo Hospital, Potenza, Italy |
Raffaella Nacca | Department of Emergency and General Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy |
Rosa Francavilla | Pediatric Department, Maggiore Hospital Carlo Alberto Pizzardi, Bologna AUSL, Bologna, Italy |
Rosa Lapolla | Department of Pediatrics, San Carlo Hospital, Potenza, Italy |
Salvatore Grosso | Clinical Paediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy |
Sergio Manieri | Department of Pediatrics, San Carlo Hospital, Potenza, Italy |
Silvia Carlassara | Department of Pediatric Emergency, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy |
Simone Ajello | Clinical Paediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy |
Stefano Masi | IRCCS Meyer University Children’s Hospital, Florence, Italy |
Viola Carzaniga | Pediatric Department, University of Milano Bicocca, Milano, Italy |
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Bezzini, D., Lanari, M., Amaddeo, A. et al. Frequency and type of domestic injuries among children during COVID-19 lockdown: what changes from the past? An Italian multicentre cohort study. Eur J Pediatr 182, 3445–3454 (2023). https://doi.org/10.1007/s00431-023-04990-6
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DOI: https://doi.org/10.1007/s00431-023-04990-6