Abstract
BackgroundEmerging evidence suggests that the reallocation of health care resources during the COVID-19 pandemic negatively impacts health care system. This study describes the epidemiology and the outcome of major trauma patients admitted to centers in France during the first wave of the COVID-19 outbreak.MethodsThis retrospective observational study included all consecutive trauma patients aged 15 years and older admitted into 15 centers contributing to the TraumaBase® registry during the first wave of the SARS-CoV-2 pandemic in France. This COVID-19 trauma cohort was compared to historical cohorts (2017–2019).ResultsOver a 4 years-study period, 5762 patients were admitted between the first week of February and mid-June. This cohort was split between patients admitted during the first 2020 pandemic wave in France (pandemic period, 1314 patients) and those admitted during the corresponding period in the three previous years (2017–2019, 4448 patients). Trauma patient demographics changed substantially during the pandemic especially during the lockdown period, with an observed reduction in both the absolute numbers and proportion exposed to road traffic accidents and subsequently admitted to traumacenters (348 annually 2017–2019 [55.4% of trauma admissions] vs 143 [36.8%] in 2020 p < 0.005). The in-hospital observed mortality and predicted mortality during the pandemic period were not different compared to the non-pandemic years.ConclusionsDuring this first wave of COVID-19 in France, and more specifically during lockdown there was a significant reduction of patients admitted to designated trauma centers. Despite the reallocation and reorganization of medical resources this reduction prevented the saturation of the trauma rescue chain and has allowed maintaining a high quality of care for trauma patients.
Highlights
Emerging evidence suggests that the reallocation of health care resources during the COVID-19 pandemic negatively impacts health care system
Despite extensive public health interventions, a large number of patients were admitted to French intensive care units, mainly with acute respiratory distress syndrome (ARDS)
The results demonstrate a significant impact on the epidemiology of trauma in France during lockdown
Summary
Emerging evidence suggests that the reallocation of health care resources during the COVID-19 pandemic negatively impacts health care system. In December 2019 Wuhan, China, experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1, 2]. This outbreak was declared a pandemic by World Health Organization, and has spread to the entire World. The COVID-19 led to a massive increase in the demand for acute care beds and challenged existing surge capacity. This required a fast and thorough restructure of the health care system [3]. A central element consisted in the postponement of non-urgent medical consultations and interventions allowing the reallocation of manpower and resources to COVID-19 patients [4]
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