Adult and pediatric emergency department visits for dermatological conditions during the COVID-19 pandemic: A multicenter analysis

Pakhchanian, H.; Raiker, R.; Russomanno, K.; Deng, M.

During the early phases of the COVID-19 pandemic, many emergency departments (EDs) across the United States experienced significant declines in patient volumes. The aim of this study was to quantify the degree to which COVID-19 impacted ED visits for adult and pediatric dermatologic conditions. A descriptive study was performed using TriNetX, a national federated real time database of 69 million records. Common dermatologic conditions were identified a priori via ICD-10 codes. The prevalence of adult and pediatric ED encounters (EDE) with each skin condition was assessed from 3/20/2020 to 3/19/2021 and compared to the preceding year. The number of EDE for any dermatological condition (ICD10: L00-L99) decreased 23% overall from 19,705 to 15,218 per 100,000 of all healthcare encounters (HCE). All dermatological disease categories assessed in both adult and pediatric patients showed a significant decrease in total EDE compared to the prior year. Diagnoses assessed included cellulitis (-38% and -53% for adult and pediatrics, respectively), other skin infections (-38%, -56%), bullous skin disorders (-46%, -53%), dermatitis/eczema (-40%, -61%), papulosquamous disorders (-35%, -64%), urticaria/erythema (-46%, -64%), radiation-related skin disorders (-44%, -38%), skin appendages disorders (-43%, -54%), and other skin disorders (-39%, -53%). Adult and pediatric ED visits for dermatological conditions significantly decreased during the pandemic compared to the prior year with decreases in pediatric ED visits being more notable. Further studies are necessary to determine if these patients received care in other settings (i.e. outpatient offices, telehealth), and associated outcomes. Future studies are also needed to examine the degree to which ED visits for dermatologic conditions resume and if COVID-19 has lasting impacts on the setting in which skin care is sought.