key: cord-0941486-phfq6jpe authors: Feng, Jihua; Yang, Yanli; Zheng, Xiaowen; Zhao, Chunling; Li, Hongyuan; Ji, Pan; Yu, Qiao; Wei, Lile; Qin, Han; Pang, Jielong; Li, Bocheng; Zhang, Jianfeng title: Impact of COVID‐19 on emergency patients in the resuscitation room: A cross‐sectional study date: 2022-01-28 journal: J Clin Lab Anal DOI: 10.1002/jcla.24264 sha: a07e5d2cd297ae523fb2766218e1a8cb21f2c37b doc_id: 941486 cord_uid: phfq6jpe OBJECTIVE: The purpose of this study was to evaluate the impact of COVID‐19 outbreaks on emergency patients in a resuscitation room in Nanning, China. METHODS: A single‐center cross‐sectional retrospective study was conducted in the emergency department of a tertiary public hospital from January 1, 2019, to December 31, 2020, in Nanning, Guangxi, China. We collected the data of patients in the resuscitation room to investigate the number of patients accessing emergency services during the study period. Data in 2020 were compared to the data during the same period in 2019. RESULTS: The number of emergency patients in the resuscitation room during the COVID‐19 pandemic has decreased in intrinsic diseases, extrinsic diseases, and pediatric cases, especially in the early stages of the pandemic. Additionally, the length of stay of emergency patients in the resuscitation room was reduced. CONCLUSIONS: The number of emergency patients in the resuscitation room during the pandemic of COVID‐19 in 2020 was reduced compared to that in the same period in 2019 in Nanning, China. This situation shows a serious social problem, which should arouse the attention of the medical profession and the government. transmission. 4 In China, rapid and strict regulatory measures have been implemented to curb the spread of the epidemic. 6 The government launched a first-level major public health response in 30 provinces from January to April and then launched a second-level response through early June. Thanks to the positive measures, the outbreak has been retarded. 7 The public health measures related to controlling the virus have led to extensive economic damage 8 but may have positive environmental impacts; for instance, reducing carbon emissions caused by travel. 9, 10 The global lockdown has also impacted the health of the population in other ways, such as reducing the spread of influenza, accidents and injuries, and possibly preterm births. Increasing evidence recommends that patients with emergencies deliberately avoid the emergency room due to worry about the risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 11 Recently, a reduction has been reported in the number of emergency calls in Hangzhou, China by 21.63%, ambulance calls by 29.02%, and rescue calls by 22 .57% in 2020 compared to those in 2019. 12 In Beijing, the emergency attendance rates were decreased in half at the beginning of the lockdown period. 13 The accident and emergency room attendance rates also significantly decreased in Hong Kong. 14 Additionally, the number of prehospital transportation events decreased in Japan and Australia in 2020. 15, 16 Guangxi is a border area located in southern China. All suspected and confirmed COVID-19 patients were strictly quarantined and treated in designated hospitals. A special procedure was implemented during the epidemic of COVID-19 in which patients with suspected of COVID-19 were isolated from the general group of patients, including those admitted via emergency department procedures. Moreover, the number and characteristics of patients in the resuscitation room during the COVID-19 pandemic might have changed significantly compared with those during the period before the pandemic. This study analyzed changes in the number and characteristics of patients in the resuscitation room before and during the COVID-19 in China. Our study was conducted at The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China, which is a tertiary public hospital serving more than 1.64 million residents, without the public sector tasked to manage suspected and confirmed COVID-19 patients, as all the COVID-19 cases were strictly quarantined and treated in the designated hospitals. This institution is tasked with managing all-cause emergency and elective inpatient and outpatient services, in addition to its normal activity of more than 160,000 emergency patients per year. We conducted an observational study with retrospective data collection to investigate the number of patients accessing emergency services. This analysis included all patients in the resuscitation room conducted by the Second Affiliated Hospital of Guangxi Medical University from January 1, 2020, to December 31, 2020. The same data were collected from January 1, 2019, to December 31, 2019, to determine whether this pandemic period differed from the same period in 2019. Data collected included basic demographic information, the number of daily and hourly emergency patients in the resuscitation room the number of intrinsic diseases, extrinsic diseases or pediatric diseases, and the length of stay of patients. To survey the relationship between the time and differences in the number and characteristics of emergency attendance in the resuscitation room, each patient interaction was assigned according to the date of the emergency visit. Two periods were defined as follows: before the pandemic period, which was chosen as the baseline period (January 1, 2019, to December 31, 2019); during the COVID-19 pandemic period from January 1, 2020, to December 31, 2020. The outcomes included the following: the number of patients in the two study periods, proportions and percentages of intrinsic diseases, extrinsic diseases and pediatric diseases, and patient demographics in the two periods studied. Continuous variables are summarized as the means ± standard deviation (SD) and were compared using the t-test or one-way ANOVA; medians and interquartile ranges (IQRs) were compared using the Kruskal-Wallis test. Categorical variables are summarized as absolute numbers or percentages. The relationship between the time period and the number of intrinsic diseases, extrinsic diseases, or pediatric diseases in 2020 was investigated using the Pearson chisquare test with magnitudes of association reported as odds ratios (ORs) with respective 95% confidence intervals (95% CIs) using before the pandemic period as a reference category. The frequency distribution of daily and hourly emergency attendance across the two studies was compared using the chi-square test. The SPSS software (version 16.0) was used for all analyses. Differences were considered statistically significant at p < 0.05. (Table 1) . Comparing 2019 with 2020, we found that in addition to the monthly number of patients in August, the number of patients in the resuscitation room during 2020 was lower than the respective num- To the best of our knowledge, this is the first report to analyze the details of the emergency patients in a resuscitation room in an undes- and their families about the fear of getting COVID-19. 17 In addition, during the lockdown period with strict regulations for social distancing, people were encouraged to avoid hospitalization for general patients with nonemergency conditions. These patients were encouraged to wait until the epidemic was controlled before admission to the hospital for nonemergency treatments. Therefore, patients with mild to moderate symptoms may choose not to go to the hospital due to a lack of medical knowledge. Patients were afraid of contracting COVID-19, and thus s postponed seeking medical aid. Many patients attempted to relieve their symptoms by voluntarily taking medications and sought help only when they could no longer manage their condition. In addition, during the COVID-19 pandemic, people 18 Therefore, the number of accidents, such as traffic accidents may have been reduced. 19 Li Chen also reported that the number of patients in the resuscitation room decreased by 23% in 2020. 20 There were fewer emergency department visits in 2020 than during the period before the epidemic in the United Diseases with significant changing trends in 2020 and 2019 services (EMS) in Israel. [21] [22] [23] However, data from the Chongqing and Guangdong China did not show significant changes in the number of patients with severe conditions. 24, 25 The discrepancy between studies is due to differences in study design, the local regulations to control the pandemic of COVID-19, the local COVID-19 infection rates, and public attitudes toward the COVID-19 pandemic. In our study, the length of stay in the resuscitation room was re- The number of emergency patients in the resuscitation room during the epidemic of COVID-19 in 2020 was reduced compared to that in the same period in 2019. It shows a serious social problem, which should arouse the attention of the medical profession and government. The change in the daily visit period of the patients in the resuscitation room in 2020 and 2019 None declared. The data that support the findings of this study are available from the corresponding author upon reasonable request. https://orcid.org/0000-0002-1516-1224 Covid-19: WHO declares pandemic because of "alarming levels" of spread, severity, and inaction Emergency medical services: COVID-19 crisis What advice can we give to travellers? -Interim recommendations Timeline of WHO's response to COVID-19 Organisation World Health. 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