Abstract
IntroductionNationally, there has been more than a 40% decrease in Emergency Department (ED) patient volume during the coronavirus disease 2019 (Covid-19) crisis, with reports of decreases in presentations of time-sensitive acute illnesses. We analyzed ED clinical presentations in a Maryland/District of Columbia regional hospital system while health mitigation measures were instituted.MethodsWe conducted a retrospective observational cohort study of all adult ED patients presenting to five Johns Hopkins Health System (JHHS) hospitals comparing visits from March 16 through May 15, in 2019 and 2020. We analyzed de-identified demographic information, clinical conditions, and ICD-10 diagnosis codes for year-over-year comparisons.ResultsThere were 36.7% fewer JHHS ED visits in 2020 compared to 2019 (43,088 vs. 27,293, P<.001). Patients 75+ had the greatest decline in visits (−44.00%, P<.001). Both genders had significant decreases in volume (−41.9%, P<.001 females vs −30.6%, P<.001 males). Influenza like illness (ILI) symptoms increased year-over-year including fever (640 to 1253, 95.8%, P<.001) and shortness of breath (2504 to 2726, 8.9%, P=.002). ICD-10 diagnoses for a number of time-sensitive illnesses decreased including deep vein thrombosis (101 to 39, −61%, P<.001), acute myocardial infarction (157 to 105, −33%, P=.002), gastrointestinal bleeding (290 to 179, −38.3%, P<.001), and strokes (284 to 234, −17.6%, P=0.03).ConclusionED visits declined significantly among JHHS hospitals despite offsetting increases in ILI complaints. Decreases in presentations of time-sensitive illnesses were of particular concern. Efforts should be taken to inform patients that EDs are safe, otherwise preventable morbidity and mortality will remain a problem.
Highlights
Nationally, there has been more than a 40% decrease in Emergency Department (ED) patient volume during the coronavirus disease 2019 (Covid-19) crisis, with reports of decreases in presentations of time-sensitive acute illnesses
The United States experienced over 1.6 million coronavirus disease 2019 (COVID-19) infections and more than 125,000 deaths as of June 29, 2020.1 The pandemic has created a public health emergency due to a combination of factors including high transmissibility, asymptomatic infectious carriers, and without widespread testing, a difficult-to-calculate infection fatality rate (IFR).[2]
The rapid onset of the Covid-19 pandemic caused hospital emergency department patient volumes to plummet throughout the nation, and this trend was evident in the Maryland and Washington, D.C. metro area as well.[3]
Summary
There has been more than a 40% decrease in Emergency Department (ED) patient volume during the coronavirus disease 2019 (Covid-19) crisis, with reports of decreases in presentations of time-sensitive acute illnesses. The United States experienced over 1.6 million coronavirus disease 2019 (COVID-19) infections and more than 125,000 deaths as of June 29, 2020.1 The pandemic has created a public health emergency due to a combination of factors including high transmissibility, asymptomatic infectious carriers, and without widespread testing, a difficult-to-calculate infection fatality rate (IFR).[2]. There has been a greater than 40% decrease in emergency department (ED) patient volume during this crisis.[3,4,5] Reports have suggested that certain time sensitive presentations. While each of these is a concern in and of itself, there has been few detailed analyses characterizing the variance in the multiplicity of patient conditions associated with the ED volume loss
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
