The authors S. Bergrath and T. Strapatsas contributed equally to the manuscript. Treten Sie in den AustauschDiese Arbeit wurde für Der Anaesthesist in Englisch eingereicht und angenommen. Die deutsche Zusammenfassung wurde daher etwas ausführlicher gestaltet. Sie finden diese an der Literatur des Artikels. Wenn Sie über die Zusammenfassung hinaus Fragen haben und mehr wissen wollen, nehmen Sie gern in Deutsch über die Korrespondenzadresse am Ende des Beitrags Kontakt auf. Die Autoren freuen sich auf den Austausch mit Ihnen.These parameters are shown in relation to the time of the following events: appearance of the first SARS-CoV-2 cases in the region, social distancing measures, case numbers of SARS-CoV-2 positive patients in Mönchengladbach and Easter holidays.The medical disciplines are summarized as follows: internal medicine, including all subspecialties; traumatology;
Background: The outbreak of the coronavirus disease 2019 (COVID-19) caused by the severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2) led to severe disruption in social life and economics. The present study should analyze the impact of the local COVID-19 epidemic on emergency resources for all hospitals in a major urban center (Moenchengladbach, Germany). Methods: An observational multicenter study was performed involving all four acute care hospitals. Systemic parameters department (ED) parameters from week 4 to 24 in 2020 were compared to the corresponding period in 2019 for each hospital and in a summative data analysis using a logistic regression model. Outcomes: ED visits, ED to hospital admission, ED to Intensive Care Unit (ICU) admission, medical specialties of admitted patients, work related accidents. Results: In week 9/2020 the first SARS-CoV-2 positive patients were detected in our region. All hospitals decided to minimize elective admissions to ensure operational capability for COVID-19 patients. The summative number of ED visits dropped from 34,659 to 28,008. Numbers decreased from week 8 on between 38% and 48% per week per hospital at the maximum and began to rise again from week 16 on. The pooled data analysis showed statistically significant decreases in outpatient ED visits (20,152 vs. 16,477, p=<0.001), hospital admissions of ED patients (14,507 vs. 11,531, p=<0.001), and work-related accidents (2,290 vs. 1,468, p=<0.001). The decrease in admissions from ED to ICU did not reach statistical significance (2,093 vs. 1,566, p=0.255). The decline in ED cases was mainly caused by a decrease in non-trauma and non-surgical patients. Conclusion: The regional COVID-19 outbreak led to significantly reduced ED contacts after the first COVID-19 cases appeared. Even the admissions to the hospitals and the number of ED to ICU-admissions decreased, which is potentially dangerous, because the ratio of emergency outpatients vs. inpatients remained stable. Therefore, one can assume that patients with severe medical problems did not seek ED care in many cases. The decline of patients was earlier than in other German hospitals and in contrast to the findings in the U.S. and Italy where ED visits and hospital admissions in medical disciplines increased.
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