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Original Research

Open Access

Changes in epidemiology of patients visiting emergency departments during the early COVID-19 pandemic period

  • Sung Joon Park1
  • Young-Hoon Yoon1
  • Ji Young Lee1
  • Eu Sun Lee1
  • Hong Seok Park2
  • Jung-Youn Kim1,*,

1Department of Emergency Medicine, College of Medicine, Korea University, 02841 Seoul, Republic of Korea

2Department of Urology, College of Medicine, Korea University, 02841 Seoul, Republic of Korea

DOI: 10.22514/sv.2024.037 Vol.20,Issue 4,April 2024 pp.15-24

Submitted: 18 November 2022 Accepted: 20 February 2023

Published: 08 April 2024

*Corresponding Author(s): Jung-Youn Kim E-mail: yellow79@korea.ac.kr

Abstract

Infectious disease outbreaks have a great influence on the use of emergency departments (EDs). The purpose of this study was to analyze the effect of the early coronavirus disease outbreak (COVID-19) on ED visits, to be able to more effectively use ED resources during infectious disease outbreaks. This was a retrospective observational study conducted in three tertiary EDs. We defined the COVID-19 period as 01 December 2019, to 30 April 2020, and the control periods were defined as the same period in 2018 and 2019. All patients who visited the EDs during the study period were included. We collected visitor data on the total number, demographics, clinical data, vital signs, acuity level, cause of visit, disposition, time of visit and diagnostic code. A total of 180,192 patients were enrolled in this study. During the COVID-19 period, the number of ED visits decreased significantly. This decline was significant since mid-February when the number of COVID-19 patients surged nationwide. The proportion of critical patients and admission rate increased while the proportion of non-emergency patients decreased significantly from February (p < 0.001). The proportion of night-time ED visits decreased significantly from March. During the COVID-19 period and pre-COVID-19 period, the top three diagnosis areas were “abdominal and pelvis pain” “fever of other and unknown origin” and “open wound in the head” and remained unchanged. “Influenza because of an identified seasonal influenza virus” decreased during the study period. The study showed the number and characteristics of ED visits changed during the COVID-19 period compared with those of pre-COVID-19 periods.


Keywords

Emergency service hospital; Pandemics; COVID-19


Cite and Share

Sung Joon Park,Young-Hoon Yoon,Ji Young Lee,Eu Sun Lee,Hong Seok Park,Jung-Youn Kim. Changes in epidemiology of patients visiting emergency departments during the early COVID-19 pandemic period. Signa Vitae. 2024. 20(4);15-24.

References

[1] Kang S, Ahn TK, Seo YH, Suh YJ, Paik JH. Comparison of emergency department utilization trends between the COVID-19 pandemic and control period. Medicine. 2021; 100: e26847.

[2] Alotaibi R, Alahmari A, Ababtain I, Altamimi A, Alkhaldi A, Alhelail M, et al. The effect of COVID-19 on the characteristics of adult emergency department visits: a retrospective cohort tertiary hospital experience in Riyadh. Journal of Infection and Public Health. 2022; 15: 132–137.

[3] Choi S, Ki M. Estimating the reproductive number and the outbreak size of COVID-19 in Korea. Epidemiology and Health. 2020; 42: e2020011.

[4] World Health Organization. WHO Coronaviurs Disease (COVID-19) Dashboard. 2023. Available at: https://covid19.who.int/ (Accessed: 12 January 2013).

[5] Korea Centers for Disease Control and Prevention. Coronavirus (COVID-19), Republic of Korea. 2023. Available at: http://ncov.mohw.go.kr/en/ (Accessed: 12 January 2023).

[6] Del Beccaro MA, Brownstein DR, Cummings P, Goldoft MJ, Quan L. Outbreak of Escherichia coli O157:H7 hemorrhagic colitis and hemolytic uremic syndrome: effect on use of a pediatric emergency department. Annals of Emergency Medicine. 1995; 26: 598–603.

[7] Heiber M, Lou WYW. Effect of the SARS outbreak on visits to a community hospital emergency department. CJEM. 2006; 8: 323–328.

[8] McDonnell WM, Nelson DS, Schunk JE. Should we fear “flu fear” itself? Effects of H1N1 influenza fear on ED use. The American Journal of Emergency Medicine. 2012; 30: 275–282.

[9] Paek SH, Kim DK, Lee JH, Kwak YH. The impact of middle east respiratory syndrome outbreak on trends in emergency department utilization patterns. Journal of Korean Medical Science. 2017; 32: 1576–1580.

[10] Chang H, Kang MW, Paek SH. Impact of the COVID-19 pandemic on emergency department utilization patterns in South Korea: a retrospective observational study. Medicine. 2022; 101: e29009.

[11] Ghaderi H, Stowell JR, Akhter M, Norquist C, Pugsley P, Subbian V. Impact of COVID-19 pandemic on emergency department visits: a regional case study of informatics challenges and opportunities. AMIA Annual Symposium Proceedings. 2021; 2021: 496–505.

[12] Adjemian J, Hartnett KP, Kite-Powell A, DeVies J, Azondekon R, Radhakrishnan L, et al. Update: COVID-19 pandemic-associated changes in emergency department visits—United States, December 2020–January 2021. MMWR. Morbidity and Mortality Weekly Report. 2021; 70: 552–556.

[13] Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al. Impact of the COVID-19 pandemic on emergency department visits—United States, January 1, 2019–May 30, 2020. MMWR. Morbidity and Mortality Weekly Report. 2020; 69: 699–704.

[14] Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE 3rd, Hoppe JA, et al. Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the us. JAMA Internal Medicine. 2020; 180: 1328–1333.

[15] Kim HS, Cruz DS, Conrardy MJ, Gandhi KR, Seltzer JA, Loftus TM, et al. Emergency department visits for serious diagnoses during the COVID-19 pandemic. Academic Emergency Medicine. 2020; 27: 910–913.

[16] Tuygun N, Karacan CD, Göktuğ A, Çağlar AA, Tekeli A, Bodur İ, et al. Evaluation of changes in pediatric emergency department utilization during COVID-19 pandemic. Archives De PéDiatrie. 2021; 28: 677–682. (In French)

[17] Jovanović M, Vukosavljević M, Dinčić D, Ratković N, Perišić N, Ilić R, et al. Medical care of patients in the emergency department of the military medical academy in Belgrade during the epidemic of COVID-19. Vojnosanit Pregl. 2021; 78: 231–235.

[18] de Jorna C, Liber M, Khalifi SE, Neggia G, Martinot A, Dubos F. Changes in pediatric emergency department visits during a COVID-19 lockdown period: an exhaustive single-center analysis. Archives De PéDiatrie. 2022; 29: 604–609. (In French)

[19] Kwon H, Kim YJ, Jo YH, Lee JH, Lee JH, Kim J, et al. The Korean Triage and Acuity Scale: associations with admission, disposition, mortality and length of stay in the emergency department. International Journal for Quality in Health Care. 2019; 31: 449–455.

[20] Westgard BC, Morgan MW, Vazquez-Benitez G, Erickson LO, Zwank MD. An analysis of changes in emergency department visits after a state declaration during the time of COVID-19. Annals of Emergency Medicine. 2020; 76: 595–601.

[21] Yu IT, Xie ZH, Tsoi KK, Chiu YL, Lok SW, Tang XP, et al. Why did outbreaks of severe acute respiratory syndrome occur in some hospital wards but not in others? Clinical Infectious Diseases. 2007; 44: 1017–1025.

[22] Kim SW, Park JW, Jung HD, Yang JS, Park YS, Lee C, et al. Risk factors for transmission of Middle East respiratory syndrome coronavirus infection during the 2015 outbreak in South Korea. Clinical infectious diseases. 2017; 64: 551–557.

[23] Harper CA, Satchell LP, Fido D, Latzman RD. Functional fear predicts public health compliance in the COVID-19 pandemic. International Journal of Mental Health and Addiction. 2021; 19: 1875–1888.

[24] Noh JY, Seong H, Yoon JG, Song JY, Cheong HJ, Kim WJ. Social Distancing against COVID-19: implication for the control of influenza. Journal of Korean Medical Science. 2020; 35: e182.

[25] Huang Y, Wu Q, Wang P, Xu Y, Wang L, Zhao Y, et al. Measures undertaken in China to avoid COVID-19 infection: internet-based, cross-sectional survey study. Journal of Medical Internet Research. 2020; 22: e18718.

[26] Carret ML, Fassa AG, Kawachi I. Demand for emergency health service: factors associated with inappropriate use. BMC Health Services Research. 2007; 7: 131.

[27] Bahadori M, Mousavi SM, Teymourzadeh E, Ravangard R. Emergency department visits for non-urgent conditions in Iran: a cross-sectional study. BMJ Open. 2019; 9: e030927.

[28] Kugelman N, Lavie O, Assaf W, Cohen N, Sagi-Dain L, Bardicef M, et al. Changes in the obstetrical emergency department profile during the COVID-19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine. 2022; 35: 4116–4122.

[29] Frumer M, Aharony SM, Shoshany O, Kedar D, Baniel J, Golan S. Trends in urological emergencies in the Era of COVID-19. International Brazilian journal of urology. 2021; 47: 997–1005.


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