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Impact of the COVID-19 Epidemic on the Routine Emergency Services in a Tertiary Hospital, China: A Retrospective Cohort Study

Published online by Cambridge University Press:  09 September 2021

Lianjing Liang ,
Zhuo Zhang ,
Ping Li ,
Shanshan Weng  and
Hu Nie Open the ORCID record for Hu Nie [Opens in a new window]
Lianjing Liang
Affiliation:
Emergency Department, West China Hospital, Sichuan University
Zhuo Zhang
Affiliation:
Emergency Department, West China Hospital, Sichuan University
Ping Li
Affiliation:
Emergency Department, West China Hospital, Sichuan University
Shanshan Weng
Affiliation:
Emergency Department, West China Hospital, Sichuan University
Hu Nie*
Affiliation:
Emergency Department, West China Hospital, Sichuan University
*
Corresponding author: Hu Nie, Email: [email protected].
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Abstract

Background:

The sudden outbreak of the COVID-19 pandemic has caused tremendous challenges to the medical system. The government and hospitals have taken robust measures to curb the spread of the deadly virus. Its impact on routine medical services is gradually being taken seriously.

Objective:

To identify the impact of the novel Coronavirus pandemic on emergency department (ED) patient flow and the performance of the routine ED service.

Methods:

This retrospective cohort study was undertaken in a tertiary public teaching hospital ED in Chengdu, China. ED data of patients were routinely collected to compare demographic, clinical characteristics and outcomes during an 8-week period from January 1, 2019 to February 25, 2020. Data were analyzed with the chi-square statistical test.

Results:

Over the study periods, there were 31855 and 25244 patients presented to the ED in 2019 and 2020 respectively. During the pandemic period in 2020, the daily number of average ED visits was lower than that in 2019 (430 ± 134.9 versus 572 ± 38.6, P = 0.00), with fewer triage 1&2 cases (145 ± 33.3 versus 178 ± 15.0, P = 0.00). Nevertheless, the mortality increased remarkably during the pandemic period in 2020 (0.2% versus 0.1%, P = 0.009), with higher APACHE II scores (28 versus 19, P = 0.022) and shorter ED elapsed time (0.2 versus 1.4 days, P = 0.016) among these death cases.

Conclusions:

The COVID-19 pandemic had an evident impact on the patient’s behavioral patterns and routine emergency services, which caused higher ED mortality.

Keywords

COVID-19ChinaAPACHE II scoremortalityemergency department
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 5 , October 2022 , pp. 2065 - 2069
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

The Johns Hopkins Coronavirus Resource Center (CRC). COVID-19 Dashboard by the center for systems science and engineering (CSSE) at Johns Hopkins University (JHU). 2020. https://coronavirus.jhu.edu/map.html. Accessed May 23, 2020.Google Scholar
Shih, G, Lynch, DJ, Denyer, S, Shammas, B. Chinese coronavirus infections, death toll soar as fifth case is confirmed in U.S. The Washington Post. January 26, 2020. https://www.washingtonpost.com/world/asia_pacific/coronavirus-china-latest-updates/2020/01/26/4603266c-3fa8-11ea-afe2-090eb37b60b1_story.html. Accessed January 27, 2020.Google Scholar
Cheng, VCC, Wong, SC, To, KKW, Ho, PL, Yuen, KY. Preparedness and proactive infection control measures against the emerging novel coronavirus in China. J Hosp Infect. 2020;104(3):254-255.CrossRefGoogle ScholarPubMed
Armocida, B, Formenti, B, Ussai, S, Palestra, F, Missoni, E. The Italian health system and the COVID-19 challenge. Lancet Public Health. 2020;5(5):e253.Google ScholarPubMed
Dzhafer, N, Papathanasiou, J. Compassionate drug use: An imperative challenge for Bulgarian health system during COVID-19. Health Policy Technol. 2020;9(3):274-275.Google ScholarPubMed
Poveda, G. Concomitant malaria, dengue and COVID-19: An extraordinary challenge for Colombia’s public health system. Curr Opin Environ Sustain. 2020;46:23-26.CrossRefGoogle ScholarPubMed
Wu, Z, McGoogan, JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020;323(13):1239-1242.Google Scholar
Shaker, MS, Oppenheimer, J, Grayson, M, et al. COVID-19: Pandemic contingency planning for the allergy and immunology clinic. J Allergy Clin Immunol Pract. 2020;8(5):1477-1488.e5.CrossRefGoogle ScholarPubMed
Kraemer, MUG, Yang, CH, Gutierrez, B, et al. The effect of human mobility and control measures on the COVID-19 epidemic in China. Preprint. medRxiv. 2020;2020.03.02.20026708.CrossRefGoogle Scholar
Tian, H, Liu, Y, Li, Y, et al. An investigation of transmission control measures during the first 50 days of the COVID-19 epidemic in China. Science. 2020;368(6491):638-642.CrossRefGoogle ScholarPubMed
Pan, A, Liu, L, Wang, C, et al. Association of public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China. JAMA. 2020;323(19):1915-1923.CrossRefGoogle ScholarPubMed
Christey, G, Amey, J, Campbell, A, Smith, A. Variation in volumes and characteristics of trauma patients admitted to a level one trauma centre during national level 4 lockdown for COVID-19 in New Zealand. N Z Med J. 2020;133(1513):81-88.Google ScholarPubMed
De Filippo, O, D’Ascenzo, F, Angelini, F, et al. Reduced rate of hospital admissions for ACS during Covid-19 Outbreak in Northern Italy. N Engl J Med. 2020;383(1):88-89.Google ScholarPubMed
Baldi, E, Sechi, GM, Mare, C, et al. Out-of-hospital cardiac arrest during the Covid-19 outbreak in Italy. N Engl J Med. 2020;383(5):496-498.CrossRefGoogle ScholarPubMed
Han, Q, Zheng, B, Agostini, M, et al. Associations of risk perception of COVID-19 with emotion and mental health during the pandemic. J Affect Disord. 2021;284:247-255.CrossRefGoogle ScholarPubMed
Vigo, D, Patten, S, Pajer, K, et al. Mental health of communities during the COVID-19 pandemic. Can J Psychiatry. 2020;65(10):681-687.Google ScholarPubMed
Xie, X, Xue, Q, Zhou, Y, et al. Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr. 2020;174(9):898-900.Google ScholarPubMed
Lai, J, Ma, S, Wang, Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976.Google ScholarPubMed
Wang, C, Pan, R, Wan, X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain Behav Immun. 2020;87:40-48.CrossRefGoogle ScholarPubMed
Yao, S, Lin, B, Liu, Y, et al. Impact of Covid-19 on the behavior of community residents with suspected transient ischemic attack. Front Neurol. 2020;11:590406.Google ScholarPubMed
Panovska-Griffiths, J, Ross, J, Elkhodair, S, Baxter-Derrington, C, Laing, C, Raine, R. Exploring overcrowding trends in an inner city emergence department in the UK before and during COVID-19 epidemic. BMC Emerg Med. 2021;21(1):43.CrossRefGoogle Scholar
Nab, M, van Vehmendahl, R, Somers, I, Schoon, Y, Hesselink, G. Delayed emergency healthcare seeking behavior by Dutch emergency department visitors during the first COVID-19 wave: A mixed methods retrospective observational study. BMC Emerg Med. 2021;21(1):56.CrossRefGoogle ScholarPubMed
Hung, KK, Walline, JH, Chan, EYY, et al. Health service utilization in Hong Kong during the COVID-19 pandemic - A cross-sectional public survey [published online ahead of print, 2020 Oct 19]. Int J Health Policy Manag. 2020;10.34172/ijhpm.2020.183.CrossRefGoogle Scholar
Leung, WCY, Lau, EHY, Kwan, P, Chang, RS. Impact of COVID-19 on seizure-related emergency attendances and hospital admissions - A territory-wide observational study. Epilepsy Behav. 2021;115:107497.CrossRefGoogle ScholarPubMed
Wang, Y, Han, W, Pan, L, et al. Impact of COVID-19 on blood centers in Zhejiang province China. Vox Sang. 2020;115(6):502-506.CrossRefGoogle Scholar
Raturi, M, Kusum, A. The blood supply management amid the COVID-19 outbreak. Transfus Clin Biol. 2020;27(3):147-151.CrossRefGoogle ScholarPubMed
Li, H, Zhang, Z, Li, P, Nie, H. Challenges and responses: A tertiary hospital in 2019-nCoV epidemic. Disaster Med Public Health Prep. 2020;14(6):808-811.CrossRefGoogle ScholarPubMed
Mitchell, R, Banks, C; Authoring working party. Emergency departments and the COVID-19 pandemic: Making the most of limited resources. Emerg Med J. 2020;37(5):258-259.Google ScholarPubMed
Antommaria, AHM, Gibb, TS, McGuire, AL, et al. Ventilator triage policies during the COVID-19 pandemic at U.S. hospitals associated with members of the association of bioethics program directors. Ann Intern Med. 2020;173(3):188-194.Google ScholarPubMed
White, DB, Lo, B. A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA. 2020;323(18):1773-1774.Google ScholarPubMed
Bledsoe, TA, Jokela, JA, Deep, NN, Snyder Sulmasy, L. Universal do-not-resuscitate orders, social worth, and life-years: Opposing discriminatory approaches to the allocation of resources during the COVID-19 pandemic and other health system catastrophes. Ann Intern Med. 2020;173(3):230-232.Google Scholar
Hong, Z, Li, N, Li, D, et al. Telemedicine during the COVID-19 pandemic: Experiences from western China. J Med Internet Res. 2020;22(5):e19577.CrossRefGoogle ScholarPubMed
Park, S, Choi, GJ, Ko, H. Information technology-based tracing strategy in response to COVID-19 in South Korea-privacy controversies. JAMA. 2020;323(21):2129-2130.Google ScholarPubMed