The influence of coronavirus disease 2019 on emergency department visits in Nanjing, China: A multicentre cross-sectional study

Abstract

Introduction Influenza has been linked to the crowding in emergency departments (ED) across the world. The impact of the Coronavirus Disease 2019 (COVID-19) pandemic on China EDs has been quite different from those during past influenza outbreaks. Our objective was to determine if COVID-19 changed ED visit disease severity during the pandemic. Methods This was a retrospective cross sectional study conducted in Nanjing, China. We captured ED visit data from 28 hospitals. We then compared visit numbers from October 2019 to February 2020 for a month-to-month analysis and every February from 2017 to 2020 for a year-to-year analysis. Inter-group chi-square test and time series trend tests were performed to compare visit numbers. The primary outcome was the proportion of severe disease visits in the EDs. Results Through February 29 th 2020, there were 93 laboratory-confirmed COVID-19 patients in Nanjing, of which 40 cases (43.01%) were first seen in the ED. The total number of ED visits in Nanjing in February 2020, were dramatically decreased ( n = 99,949) in compared to January 2020 ( n = 313,125) and February 2019 ( n = 262,503). Except for poisoning, the severe diseases in EDs all decreased in absolute number, but increased in proportion both in year-to-year and month-to-month analyses. This increase in proportional ED disease severity was greater in higher-level referral hospitals when compared year by year. Conclusion The COVID-19 outbreak has been associated with decreases in ED visits in Nanjing, China, but increases in the proportion of severe ED visits.

Assessing the Impact of the COVID-19 Pandemic on Emergency Department Use for Patients Undergoing Cancer-Directed Surgeries

“…The drop in ED use in the general population observed in our study is in keeping with other jurisdictions [5]. This is not particularly surprising given the messaging around minimizing in-person visits to help mitigate exposure and transmission, particularly during the early pandemic period [3,4]. Even though there was a substantial decrease in overall ED rates in the general population, there was no significant decrease in ED use among surgical patients.…”

“…Cancer patients are a vulnerable population with increased risk of morbidity and mortality from COVID-19 [1,2]. To help reduce the risk of exposure and transmission, the healthcare sector pivoted toward minimizing in-person visits, including for cancer care [3,4]. Not surprisingly, in the early days of the pandemic, there were drops as large as 89% in the use of the emergency departments (ED), and patients presenting in-person had much higher acuity problems [5].…”

The effect of the COVID‐19 pandemic on dermatology consultation requests from adult and paediatric emergency departments

“…The number of ED presentations during the COVID‐19 pandemic has decreased significantly in Turkey, 11 as it has worldwide. 12 , 13 A significant drop in ED presentations because of non‐urgent complaints as well as those related to trauma, and cardiological and cerebrovascular events have been observed. 4 The present findings show that the number of presentations to the PED and AED because of dermatological complaints decreased significantly during the COVID‐19 pandemic, especially between March and May 2020, as reported elsewhere.…”

Disruption of Pediatric Emergency Department Use during the COVID-19 Pandemic

“…A growing body of literature has documented substantial declines in pediatric ED visits during the COVID-19 pandemic in several countries 13–15 . In the United States, such declines have been confirmed by studies using data from single and multiple EDs, and declines in overall visits as well as declines in visits for specific health conditions have been documented 1,5,7,8 …”