Stranger Months: How SARS-CoV-2, Fear of Contagion, and Lockdown Measures Impacted Attendance and Clinical Activity During February and March 2020 at an Urban Emergency Department in Milan

被引：32

作者：

Franchini, Stefano ^{[1
]}

Spessot, Marzia ^{[1
]}

Landoni, Giovanni ^{[1
,2
]}

Piani, Cecilia ^{[1
]}

Cappelletti, Chiara ^{[1
]}

Mariani, Federica ^{[1
]}

Mauri, Simona ^{[1
]}

Taglietti, Maria Vittoria ^{[1
]}

Fortunato, Manuela ^{[1
]}

Furlan, Federico ^{[1
]}

Guglielmi, Barbara ^{[1
]}

Setti, Eleonora ^{[1
]}

Di Napoli, Davide ^{[1
]}

Borghi, Giovanni ^{[1
]}

Pascucci, Federico ^{[2
]}

Ujlaki-Formenti, George ^{[2
]}

Sannicandro, Riccardo ^{[1
]}

Moro, Matteo ^{[1
]}

Colombo, Sergio ^{[1
]}

Dagna, Lorenzo ^{[1
]}

Castagna, Antonella ^{[2
]}

Tresoldi, Moreno ^{[1
]}

Rovere-Querini, Patrizia ^{[2
]}

Ambrosio, Alberto ^{[1
]}

Ciceri, Fabio ^{[1
,2
]}

Zangrillo, Alberto ^{[1
,2
]}

Carlucci, Michele ^{[1
]}

Faccincani, Roberto ^{[1
]}

机构：

[1] IRCCS San Raffaele Sci Inst, Milan, Italy

[2] Univ Vita Salute San Raffaele, Milan, Italy

来源：

DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS | 2021年 / 15卷 / 05期

关键词：

COVID-19; emergency department; direct and indirect impact; OUTBREAK; INFLUENZA; EBOLA;

D O I：

10.1017/dmp.2020.265

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Objectives: An unprecedented wave of patients with acute respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) hit emergency departments (EDs) in Lombardy, starting in the second half of February 2020. This study describes the direct and indirect impacts of the SARS-CoV-2 outbreak on an urban major-hospital ED. Methods: Data regarding all patients diagnosed with COVID-19 presenting from February 1 to March 31, 2020, were prospectively collected, while data regarding non-COVID patients presenting within the same period in 2019 were retrospectively retrieved. Results: ED attendance dropped by 37% in 2020. Two-thirds of this reduction occurred early after the identification of the first autochthonous COVID-19 case in Lombardy, before lockdown measures were enforced. Hospital admissions of non-COVID patients fell by 26%. During the peak of COVID-19 attendance, the ED faced an extraordinary increase in: patients needing oxygen (+239%) or noninvasive ventilation (+725%), transfers to the intensive care unit (+57%), and in-hospital mortality (+309%), compared with the same period in 2019. Conclusions: The COVID-19 outbreak determined an unprecedented upsurge in respiratory failure cases and mortality. Fear of contagion triggered a spontaneous, marked reduction of ED attendance, and, presumably, some as yet unknown quantity of missed or delayed diagnoses for conditions other than COVID-19.

引用

页码：E33 / E42

页数：10

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