Changes in the use of Otorhinolaryngology Emergency Department during the COVID-19 pandemic: report from Lombardy, Italy

Abstract

Purpose. This paper aims to report the impact of COVID-19 outbreak on Emergency Ear nose and Throat (ENT) activity, in Lombardy (Italy), during COVID-19 pandemic.Methods. The number of accesses to Emergency Department requiring ENT consultations between February 21st and May 7th, 2020, was retrospectively collected, along with the conditions treated. Data were stratified in one-week time spans, in order to evaluate the evolving trends during the on-going epidemic and a comparison with the two previous years was performed. Results. A significant reduction in the number of consultations performed during the pandemic was observed, as high as - 91% compared to the same period of 2018. Conclusion. Multiple reasons can explain such a reduction of Emergency ENT consultations, not least the fear of potentially being infected by SARS-Cov-2 by while accessing the hospital. The analysis performed might be useful as a starting point for a future reorganization of first aid consultations once the epidemic will be resolved.

ENT emergencies during the first wave of COVID-19 pandemic in Spain: Our experience

“…It was necessary to adapt the public health system to the epidemiological situation, reorganizing hospitals and restructuring PC, limiting surgical activity to essential cases (emergencies and oncology) and improving the distribution of health resources (human, material and structural) [ [8] , [9] , [10] , [11] ]. Attention in the general emergency services was found to be irremediably focused on the care of COVID-19 patients given the expansion of the disease, and was largely the object of the logistical and personnel restructuring undertaken by the public health system [ 2 , 3 , [12] , [13] , [14] ]. For this reason, the objective of this study was to analyze the impact of COVID-19 on the assistance to the ENT-ED.…”

“…The volume of patients attended in the ENT-ED during the established period registered a statistically significant decrease of 48,26% with respect to the consultations attended the previous year. Studies in other European countries, such as Italy, show much more pronounced decreases, between 62% and 81% with respect to the activity in 2019 [ 2 , 3 ], with peaks reaching 90% [ 3 ]. This decrease correlates significantly with the epidemiological situation in our health area ( Fig.…”

“…Emergency services were one of the main target sectors of the reorganization of the system, given its importance as the first point of contact with many patients, in a situation in which PC was also exhausted. In this sense, the emergency care in ENT patients has also been altered following the onset of the COVID-19 outbreak, and, seemingly, many non-COVID-19 illnesses have been disappearing [ 2 , 3 ].…”

The Impact of the lockdown on ENT services during the COVID-19 Pandemic, a report from the developing world.

“…A possible factor in the decrease in number of scheduled visits was the number of public holidays during the post-lockdown period but even accounting for this the number of scheduled visits was meaningfully decreased. [5] Our out-patient clinic attendance rate post-lockdown decreased (76.8%) but paled in comparison to published data [1]. Kasle et al (2020) conducted a retrospective review within the Division of Otolaryngology at the Yale School of Medicine to examine the quantitative changes in patient visits, modality of their care and subspecialty practice patterns during a selected period in the COVID-19 pandemic and compared it to the same period in 2019.…”

“…The postponement is in line with measures adopted by comparable departments in Italy, a country which adopted a similar severe lockdown. [5,6] The decrease in the number of surgical procedures performed during the post-lockdown period was deemed insigni cant (p=0.67). A study by Ralli et al documented a 50.8% decrease in the number of ENT procedures done.…”