Abstract
BackgroundDuring March and April 2020, reductions in non-COVID-19 hospital admissions were observed around the world. Elective surgeries, visits with general practitioners, and diagnoses of medical emergencies were consequently delayed.Objective To compare the characteristics of patients admitted to a northern Israeli hospital with common surgical complaints during three periods: the lockdown due to the COVID-19 outbreak, the Second Lebanon War in 2006, and a regular period.MethodsDemographic, medical, laboratory, imaging, intraoperative, and pathological data were collected from electronic medical files of patients who received emergency treatment at the surgery department of a single hospital in northern Israel. We retrospectively compared the characteristics of patients who were admitted with various conditions during three periods.Results Patients’ mean age and most of the clinical parameters assessed were similar between the periods. However, pain was reportedly higher during the COVID-19 than the control period (8.7 vs. 6.4 on a 10-point visual analog scale, P < 0.0001). During the COVID-19 outbreak, the Second Lebanon War, and the regular period, the mean numbers of patients admitted daily were 1.4, 4.4, and 3.0, respectively. The respective mean times from the onset of symptoms until admission were 3, 1, and 1.5 days, P < 0.001. The respective proportions of surgical interventions for appendiceal disease were 95%, 96%, and 69%; P = 0.03.ConclusionsCompared to a routine period, patients during the COVID-19 outbreak waited longer before turning to hospitalization, and reported more pain at arrival. Patients during both emergency periods were more often treated surgically than non-operatively.
Highlights
During March and April 2020, reductions in non-COVID-19 hospital admissions were observed around the world
During the COVID-19 period, the percentage of patients presenting at the surgical department with diabetes was lower and the percentage with COPD was higher than during the other periods examined
Clinical and laboratory variables did not differ between the groups including heart rate, mean arterial pressure, body temperature, white blood cell count (WBC) and C-reactive protein (CRP)
Summary
During March and April 2020, reductions in non-COVID-19 hospital admissions were observed around the world. Despite the decrease in ED visits most studies reported no change in the rate of admissions. This discrepancy was suggested to be caused by the higher acuity of patients presented to the ED, in some cases resulting from a delayed presentation [2,3,4]. The Israeli government had enforced restrictions similar to other countries, and on March 19th had declared a state of emergency. During the state of emergency all Israeli residents were to remain within 100meter radius of their home except for essential needs and medical emergencies. On July 15th the Israeli Minister of Defense declared the state of emergency, which lasted one month
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