Medical Emergencies During the COVID-19 Pandemic.
Journal
Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967
Informations de publication
Date de publication:
17 08 2020
17 08 2020
Historique:
received:
18
05
2020
revised:
18
05
2020
accepted:
06
07
2020
entrez:
1
9
2020
pubmed:
1
9
2020
medline:
5
9
2020
Statut:
ppublish
Résumé
In this study, we investigate the number of emergency room consultations during the COVID-19 pandemic of 2020 in Germany compared to figures from the previous year. Case numbers from calendar weeks 1 through 22 of the two consecutive years 2019 and 2020 were obtained from 29 university hospitals and 7 non-university hospitals in Germany. Information was also obtained on the patients' age, sex, and urgency, along with the type of case (outpatient/inpatient), admitting ward, and a small number of tracer diagnoses (I21, myocardial infarction; J44, COPD; and I61, I63, I64, G45, stroke /TIA), as well as on the number of COVID-19 cases and of tests performed for SARS-CoV-2, as a measure of the number of cases in which COVID-19 was suspected or at least included in the differential diagnoses. A total of 1 022 007 emergency room consultations were analyzed, of which 546 940 took place in 2019 and 475 067 in 2020. The number of consultations with a positive test for the COVID-19 pathogen was 3122. The total number of emergency room consultations in the observation period was 13% lower in 2020 than in 2019, with a maximum drop by 38% coinciding with the highest number of COVID-19 cases (calendar week 14; 572 cases). After the initiation of interpersonal contact restrictions in 2020, there was a marked drop in COVID-19 case numbers, by a mean of -240 cases per week per emergency room (95% confidence interval [-284; -128]). There was a rise in case numbers thereafter, by a mean of 17 patients per week [14; 19], and the number of cases of myocardial infarction returned fully to the level seen in 2019. In Germany, the COVID-19 pandemic led to a significant drop in medical emergencies of all kinds presenting to the nation's emergency departments. A recovery effect began to be seen as early as calendar week 15, but the levels seen in 2019 were not yet reached overall by calendar week 22; only the prevalence of myocardial infarction had renormalized by then. The reasons for this require further investigation.
Sections du résumé
BACKGROUND
In this study, we investigate the number of emergency room consultations during the COVID-19 pandemic of 2020 in Germany compared to figures from the previous year.
METHODS
Case numbers from calendar weeks 1 through 22 of the two consecutive years 2019 and 2020 were obtained from 29 university hospitals and 7 non-university hospitals in Germany. Information was also obtained on the patients' age, sex, and urgency, along with the type of case (outpatient/inpatient), admitting ward, and a small number of tracer diagnoses (I21, myocardial infarction; J44, COPD; and I61, I63, I64, G45, stroke /TIA), as well as on the number of COVID-19 cases and of tests performed for SARS-CoV-2, as a measure of the number of cases in which COVID-19 was suspected or at least included in the differential diagnoses.
RESULTS
A total of 1 022 007 emergency room consultations were analyzed, of which 546 940 took place in 2019 and 475 067 in 2020. The number of consultations with a positive test for the COVID-19 pathogen was 3122. The total number of emergency room consultations in the observation period was 13% lower in 2020 than in 2019, with a maximum drop by 38% coinciding with the highest number of COVID-19 cases (calendar week 14; 572 cases). After the initiation of interpersonal contact restrictions in 2020, there was a marked drop in COVID-19 case numbers, by a mean of -240 cases per week per emergency room (95% confidence interval [-284; -128]). There was a rise in case numbers thereafter, by a mean of 17 patients per week [14; 19], and the number of cases of myocardial infarction returned fully to the level seen in 2019.
CONCLUSION
In Germany, the COVID-19 pandemic led to a significant drop in medical emergencies of all kinds presenting to the nation's emergency departments. A recovery effect began to be seen as early as calendar week 15, but the levels seen in 2019 were not yet reached overall by calendar week 22; only the prevalence of myocardial infarction had renormalized by then. The reasons for this require further investigation.
Identifiants
pubmed: 32865489
pii: arztebl.2020.0545
doi: 10.3238/arztebl.2020.0545
pmc: PMC8171546
doi:
pii:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
545-552Investigateurs
Volker Burst
(V)
Michael Bernhard
(M)
Sabine Blaschke
(S)
Viktoria Bogner-Flatz
(V)
Markus Wörnle
(M)
Jörg C. Brokmann
(JC)
Felix Hans
(F)
Katharina Dechant
(K)
Michael Dommasch
(M)
Karl Georg Kanz
(KG)
Jennifer Hitzek
(J)
Tobias Hofmann
(T)
Sebastian Ewen
(S)
Ingo Gräff
(I)
André Gries
(A)
Andreas Jerrentrup
(A)
Lars Kihm
(L)
Joachim Riße
(J)
Florian Kreth
(F)
Nicole Wielander
(N)
Philipp Kümpers
(P)
Ulrich Mayer-Runge
(U)
Matthias Napp
(M)
Domagoj Schunk
(D)
Rajan Somasundaram
(R)
Markus Wehler
(M)
Sebastian Wolfrum
(S)
Martin Kulla
(M)
Caroline Grupp
(C)
Christian Pietsch
(C)
Oliver Horn
(O)
Heike Höger-Schmidt
(H)
Rupert Grashey
(R)
Thomas J. Henke
(TJ)
Kirsten Habbinga
(K)
Références
N Engl J Med. 2020 Jul 2;383(1):88-89
pubmed: 32343497
Stud Health Technol Inform. 2014;205:750-4
pubmed: 25160287
Eur Heart J Qual Care Clin Outcomes. 2020 Jul 1;6(3):210-216
pubmed: 32467968
Eur J Emerg Med. 2020 Jun;27(3):161-162
pubmed: 32224710
Med Klin Intensivmed Notfmed. 2020 Apr;115(3):175-177
pubmed: 32166350
N Engl J Med. 2019 Jan 10;380(2):171-176
pubmed: 30625066
Dtsch Med Wochenschr. 2020 May;145(10):657-664
pubmed: 32344439
N Engl J Med. 2008 Jan 31;358(5):475-83
pubmed: 18234752
Circulation. 2020 Jun 16;141(24):2035-2037
pubmed: 32352318
Eur J Emerg Med. 2018 Aug;25(4):295-299
pubmed: 28145941
J Am Coll Cardiol. 2020 Jun 9;75(22):2871-2872
pubmed: 32283124
Lancet. 2020 Apr 4;395(10230):1110-1111
pubmed: 32220279
JAMA. 2020 Jul 7;324(1):96-99
pubmed: 32501493
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104953
pubmed: 32689621
Med Klin Intensivmed Notfmed. 2018 Mar;113(2):115-123
pubmed: 28447144
Lancet. 2020 May 23;395(10237):e93-e94
pubmed: 32416787
Nature. 2020 Mar;579(7798):270-273
pubmed: 32015507
N Engl J Med. 1996 Dec 26;335(26):2001
pubmed: 8975138
BMJ Open. 2016 Nov 16;6(11):e013323
pubmed: 27852722
Dtsch Arztebl Int. 2020 Apr 17;117(16):271-278
pubmed: 32519944
Eur J Neurol. 2020 Sep;27(9):1783-1787
pubmed: 32399995
Med Klin Intensivmed Notfmed. 2020 Nov;115(8):668-681
pubmed: 31197419
N Engl J Med. 2020 Jul 23;383(4):400-401
pubmed: 32383831
J Sports Sci. 2019 Dec;37(24):2826-2834
pubmed: 31500501
J Formos Med Assoc. 2006 Jan;105(1):31-7
pubmed: 16440068