• Adrienne L Davis, Alia Sunderji, Shashidhar R Marneni, Michelle Seiler, Jeanine E Hall, CotandaCristina ParraCPPediatric Emergency Department, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain., Eileen J Klein, Julie C Brown, Renana Gelernter, Mark A Griffiths, Julia Hoeffe, Gianluca Gualco, Ahmed Mater, Sergio Manzano, Graham C Thompson, Sara Ahmed, Samina Ali, Ran D Goldman, and International COVID-19 Parental Attitude Study (COVIPAS) Group.
• Pediatric Emergency Medicine, Hospital for Sick Children and Department of Pediatrics, University of Toronto, 555 University Ave, Toronto, ON, M5G 1X8, Canada. adrienne.davis@sickkids.ca.
• CJEM. 2021 Nov 1; 23 (6): 778-786.

ObjectiveTo determine if caregivers of children presenting to pediatric emergency departments (EDs) during the COVID-19 pandemic are delaying presenting to care for fear of contracting COVID-19.MethodsThis was a pre-planned secondary analysis of a cross-sectional survey study of caregivers accompanying their children aged 0-19 years to 16 pediatric EDs in 5 countries from May to June 2020. An anonymous online survey, completed by caregivers via RedCAP, included caregiver and child demographics, presenting complaints, if they delayed presentation and whether symptoms worsened during this interval, as well as caregiver concern about the child or caregiver having COVID-19 at the time of ED visit.ResultsOf 1543 caregivers completing the survey, 287 (18.6%) reported a delay in seeking ED care due to concerns of contracting COVID-19 in the hospital. Of those, 124 (43.2%) stated their child's symptoms worsened during the waiting interval. Caregiver relationship to child [mother] (OR 1.85, 95% CI 1.27-2.76), presence of chronic illness in child (OR 1.78. 95% CI 1.14-2.79), younger age of caregiver (OR 0.965, 95% CI 0.943-0.986), and caregiver concerns about lost work during the pandemic (OR 1.08, 95% CI 1.04-1.12) were independently associated with a COVID-19-related delayed presentation in multivariable regression analysis.ConclusionsAlmost one in five caregivers reported delaying ED presentation for their ill or injured child specifically due to fear of contracting COVID-19 while in hospital, with mothers, younger caregivers, caregivers of children with chronic illness, and those concerned about lost work more likely to report delaying ED presentation.© 2021. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).

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