Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020

Czeisler, Mark É; Marynak, Kristy; Clarke, Kristie E N; Salah, Zainab; Shakya, Iju; Thierry, J.; Ali, Nida; McMillan, Hannah; Wiley, Joshua F.; Weaver, Matthew D.; Czeisler, Charles A.; Rajaratnam, Shantha M W; Howard, Mark

doi:10.15585/mmwr.mm6935e3

Cited by 65 publications

(40 citation statements)

References 7 publications

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“…5 This decline may be secondary to a combination of social restrictions, apprehensions in seeking care at a medical center, and increased parental supervision due to work-from-home advisories. 5,6 The majority of ingestions occurred at the home, aligning with school and childcare closures during the pandemic.…”

Section: Discussionmentioning

confidence: 99%

“…This may have subsequently contributed to delays in presentations and potentially worse outcomes. 6 The increase in the proportions of adolescent and intentional ingestions may reflect heightened social, emotional, and psychological stressors on this age group. Initiatives focusing on implementing support systems for this vulnerable population are warranted.…”

Section: Discussionmentioning

confidence: 99%

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COVID-19 and Pediatric Ingestions

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

COVID-19 and Pediatric Ingestions

et al. 2021

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“…First, despite the widespread adoption of telemedicine, the US Centers for Disease Control and Prevention estimates that as of June 2020, 41% of US adults delayed or avoided medical care during the pandemic, including 12% who avoided urgent or emergency care. 14 These delays in care may increase morbidity or mortality. In addition, while telemedicine is effective for history-taking and some elements of the physical exam, there are still significant limitations to the virtual physical exam.…”

Section: Discussionmentioning

confidence: 99%

Internal carotid artery aneurysm presenting as diplopia via telemedicine during COVID-19

2021

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A patient presented with acute onset of double vision during the start of the COVID-19 pandemic when elective medical care was restricted. Initially declining an in-person evaluation, she was examined using a telehealth video visit, incorporating multiple technological modalities to ascertain ophthalmic examination elements. Her findings prompted emergent neuroimaging, revealing a giant internal carotid artery aneurysm, which was successfully embolized to prevent debilitating and possibly fatal intracranial haemorrhage. This case report illustrates the successful use of telemedicine and remote patient data acquisition to make a life-saving diagnosis.

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“…Substantial delays have been reported in other populations during COVID-19 due to fear, however this may not be the case for patients with traumatic hip fractures who may not be mobile after their injury [12,[17][18][19]. Meanwhile the time from arrival to surgical intervention was similar for pre-pandemic patients and pandemic patients and was remarkably fast.…”

Section: Discussionmentioning

confidence: 99%

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic 

Jarvis¹,

Salottolo²,

Madayag

et al. 2021

Preprint

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Background: Concerns of contracting the highly contagious disease COVID-19 have led to a reluctance in seeking medical attention, which may contribute to delayed hospital arrival among traumatic patients. The study objective was to describe differences in time from injury to arrival for patients with traumatic hip fractures admitted during the pandemic to pre-pandemic patients. Materials and Methods: This retrospective cohort study at six level I trauma centers included patients with traumatic hip fractures. Patients with a non-fall mechanism and those who were transferred in were excluded. Patients admitted 3/16/2019-6/30/2019 were in the “pre-pandemic” group, patients were admitted 3/16/2020-6/30/2020 were in the “pandemic” group. The primary outcome was time from injury to arrival. Secondary outcomes were time from arrival to surgical intervention, hospital length of stay (HLOS), and mortality. Results: There were 703 patients, 352 (50.1%) pre-pandemic and 351 (49.9%) during the pandemic. Overall, 66.5% were female and the median age was 82 years old. Patients were similar in age, race, gender, and injury severity score. The median time from injury to hospital arrival was statistically shorter for pre-pandemic patients when compared to pandemic patients, 79.5 (56, 194.5) minutes vs. 91 (59, 420), p=0.04. The time from arrival to surgical intervention (p=0.64) was statistically similar between groups. For both groups, the median HLOS was 5 days, p=0.45. In-hospital mortality was significantly higher during the pandemic, 1.1% vs 3.4%, p=0.04.Conclusions: While time from injury to hospital arrival was statistically longer during the pandemic, the difference may not be clinically important. Time from arrival to surgical intervention remained similar, despite changes made to prevent COVID-19 transmission. Physicians should anticipate a slightly delayed arrival for hip fractures and provide prompt evaluation to reach definitive care in a timely manner.

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Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020

Cited by 65 publications

References 7 publications

COVID-19 and Pediatric Ingestions

COVID-19 and Pediatric Ingestions

Internal carotid artery aneurysm presenting as diplopia via telemedicine during COVID-19

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic

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Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020

Cited by 65 publications

References 7 publications

COVID-19 and Pediatric Ingestions

COVID-19 and Pediatric Ingestions

Internal carotid artery aneurysm presenting as diplopia via telemedicine during COVID-19

Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic&nbsp;

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Product

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Delayed Hospital Admission for Traumatic Hip Fracture During the COVID-19 Pandemic