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Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?

Background and objectives: the emergency department (ED) is frequently identified by patients as a possible solution for all healthcare problems, leading to a high rate of misuse of the ED, possibly causing overcrowding. The coronavirus disease 2019 (COVID-19) pandemic started in China; it then spre...

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Autores principales: Ojetti, Veronica, Covino, Marcello, Brigida, Mattia, Petruzziello, Carmine, Saviano, Angela, Migneco, Alessio, Candelli, Marcello, Franceschi, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599851/
https://www.ncbi.nlm.nih.gov/pubmed/33019514
http://dx.doi.org/10.3390/medicina56100512
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author Ojetti, Veronica
Covino, Marcello
Brigida, Mattia
Petruzziello, Carmine
Saviano, Angela
Migneco, Alessio
Candelli, Marcello
Franceschi, Francesco
author_facet Ojetti, Veronica
Covino, Marcello
Brigida, Mattia
Petruzziello, Carmine
Saviano, Angela
Migneco, Alessio
Candelli, Marcello
Franceschi, Francesco
author_sort Ojetti, Veronica
collection PubMed
description Background and objectives: the emergency department (ED) is frequently identified by patients as a possible solution for all healthcare problems, leading to a high rate of misuse of the ED, possibly causing overcrowding. The coronavirus disease 2019 (COVID-19) pandemic started in China; it then spread throughout Italy, with the first cases confirmed in Lombardy, Italy, in February 2020. This has totally changed the type of patients referred to EDs. The aim of this study was to analyze the reduction of ED admissions at a Second level urban teaching (Fondazione Policlinico Universitario Agostino Gemelli IRCCS) during the COVID-19 pandemic. Materials and Methods: in this retrospective observational cross-sectional study, we reviewed and compared clinical records of all the patients consecutively admitted to our ED over a 40-day period (21 February –31 March) in the last three years (2018–2019–2020). Mean age, sex, triage urgency level, day/night admission, main presentation symptom, and final diagnosis, according to different medical specialties, hospitalization, and discharge rate, were analyzed. Results: we analyzed 16,281 patient clinical records. The overall reduction in ED admissions in 2020 was 37.6% compared to 2019. In 2020, we observed an increase in triage urgency levels for ED admissions (the main presentation symptom was a fever). We noticed a significant drop in admissions for cardio-thoracic, gastroenterological, urological, otolaryngologic/ophthalmologic, and traumatological diseases. Acute neurological conditions registered only a slight, but significant, reduction. Oncology admissions were stable. Admissions for infectious diseases were 30% in 2020, compared to 5% and 6% in 2018 and 2019, respectively. In 2020, the hospitalization rate increased to 42.9% compared to 27.7%, and 26.4% in previous years. Conclusions: the drastic reduction of ED admissions during the pandemic may be associated with fear of the virus, suggesting that patients with serious illnesses did not go to the emergency room. Moreover, there was possible misuse of the ED in the previous year. In particular, worrisome data emerged regarding a drop in cardiology and neurology admissions. Those patients postponed medical attention, possibly with fatal consequences, just for fear of exposure to COVID-19, leading to unnecessary morbidity and mortality.
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spelling pubmed-75998512020-11-01 Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone? Ojetti, Veronica Covino, Marcello Brigida, Mattia Petruzziello, Carmine Saviano, Angela Migneco, Alessio Candelli, Marcello Franceschi, Francesco Medicina (Kaunas) Article Background and objectives: the emergency department (ED) is frequently identified by patients as a possible solution for all healthcare problems, leading to a high rate of misuse of the ED, possibly causing overcrowding. The coronavirus disease 2019 (COVID-19) pandemic started in China; it then spread throughout Italy, with the first cases confirmed in Lombardy, Italy, in February 2020. This has totally changed the type of patients referred to EDs. The aim of this study was to analyze the reduction of ED admissions at a Second level urban teaching (Fondazione Policlinico Universitario Agostino Gemelli IRCCS) during the COVID-19 pandemic. Materials and Methods: in this retrospective observational cross-sectional study, we reviewed and compared clinical records of all the patients consecutively admitted to our ED over a 40-day period (21 February –31 March) in the last three years (2018–2019–2020). Mean age, sex, triage urgency level, day/night admission, main presentation symptom, and final diagnosis, according to different medical specialties, hospitalization, and discharge rate, were analyzed. Results: we analyzed 16,281 patient clinical records. The overall reduction in ED admissions in 2020 was 37.6% compared to 2019. In 2020, we observed an increase in triage urgency levels for ED admissions (the main presentation symptom was a fever). We noticed a significant drop in admissions for cardio-thoracic, gastroenterological, urological, otolaryngologic/ophthalmologic, and traumatological diseases. Acute neurological conditions registered only a slight, but significant, reduction. Oncology admissions were stable. Admissions for infectious diseases were 30% in 2020, compared to 5% and 6% in 2018 and 2019, respectively. In 2020, the hospitalization rate increased to 42.9% compared to 27.7%, and 26.4% in previous years. Conclusions: the drastic reduction of ED admissions during the pandemic may be associated with fear of the virus, suggesting that patients with serious illnesses did not go to the emergency room. Moreover, there was possible misuse of the ED in the previous year. In particular, worrisome data emerged regarding a drop in cardiology and neurology admissions. Those patients postponed medical attention, possibly with fatal consequences, just for fear of exposure to COVID-19, leading to unnecessary morbidity and mortality. MDPI 2020-10-01 /pmc/articles/PMC7599851/ /pubmed/33019514 http://dx.doi.org/10.3390/medicina56100512 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ojetti, Veronica
Covino, Marcello
Brigida, Mattia
Petruzziello, Carmine
Saviano, Angela
Migneco, Alessio
Candelli, Marcello
Franceschi, Francesco
Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
title Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
title_full Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
title_fullStr Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
title_full_unstemmed Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
title_short Non-COVID Diseases during the Pandemic: Where Have All Other Emergencies Gone?
title_sort non-covid diseases during the pandemic: where have all other emergencies gone?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599851/
https://www.ncbi.nlm.nih.gov/pubmed/33019514
http://dx.doi.org/10.3390/medicina56100512
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