Acute Poisoning in Children Presenting to the Pediatric Emergency Department: An Epidemiologic Study and the Impact of the SARS-CoV-2 Pandemic

<i>Background and Objectives</i>: Acute poisoning is a frequent cause of pediatric emergency department visits and represents a significant public health issue, with children particularly vulnerable due to developmental and behavioral factors. This study aimed to characterize the clinical and demographic profiles of pediatric patients presenting with acute intoxication over a ten-year period (2014-2023) and to assess the impact of the SARS-CoV-2 pandemic on patterns of pediatric poisoning. <i>Materials and Methods</i>: A retrospective cohort study was conducted at the Fondazione Policlinico A. Gemelli in Rome, including all patients under 18 years presenting with acute intoxication between September 2014 and June 2023. Data were extracted from electronic medical records and categorized by age group (0-5, 6-11, and 12-18 years) and by three pandemic-related periods: Pre-COVID-19 (to March 2020), COVID-19 (March 2020-June 2021), and Post-COVID-19 (June 2021 onwards). Statistical analyses included chi-squared tests and Cramér's V for effect size. <i>Results</i>: Of 794 PED admissions for acute intoxication, 64.5% involved children aged 0-5 years, and 24.9% involved adolescents. Most events occurred at home (63.2%) and were accidental (76.4%), with voluntary intoxications exclusively among adolescents. Drug ingestion was the leading cause (39.3%), followed by solvents (17.8%) and alcohol (7.8%), with alcohol-related cases rising markedly post-pandemic. Statistically significant associations were found between the pandemic period and both age group and intentionality of poisoning (<i>p</i> < 0.00001), but not gender. Voluntary and recreational intoxications increased during and after the pandemic, particularly among adolescents. <i>Conclusions</i>: Pediatric acute poisoning displays a bimodal age distribution, with accidental exposures predominant in young children, and intentional cases predominant in adolescents. The COVID-19 pandemic was associated with an increase in adolescent voluntary and recreational intoxications. These findings underscore the need for targeted prevention strategies addressing both household safety for young children and mental health and substance use interventions for adolescents.