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Medical and cardio-vascular emergency department visits during the COVID-19 pandemic in 2020: is there a collateral
Anna Slagman1, Mareen Pigorsch2, Felix Greiner3
1Health Services Research in Emergency and Acute Medicine, Emergency and Acute Medicine CVK, CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany. anna.slagman@charite.de.
Insights
Emergency department visits decreased during the COVID-19 pandemic, but critical cardiovascular conditions like myocardial infarction and heart failure saw fewer changes. Long-term impacts require further study.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly impacted healthcare utilization globally.
- Understanding its effect on emergency department (ED) visits, particularly for cardiovascular emergencies, is crucial.
Purpose of the Study:
- To compare emergency department (ED) consultations in Germany during the 2020 COVID-19 pandemic with 2019 data.
- To specifically analyze trends in myocardial infarction and acute heart failure consultations.
Main Methods:
- Retrospective analysis of aggregated case numbers from 33 German hospitals (24 university, 9 non-university) for 2019 and 2020.
- Data included age, gender, triage scores, disposition, care level, and ICD-10 codes for myocardial infarction (I21) and heart failure (I50).
Main Results:
- A total of 2,216,627 ED consultations were analyzed, with a 14% median decrease in 2020 compared to 2019.
- While overall ED visits dropped, especially during pandemic waves, myocardial infarction and heart failure admissions remained comparable to the previous year.
- Declines were most pronounced in younger, less urgent, and non-admitted cases, particularly during the second wave.
Conclusions:
- Emergency department visits significantly decreased during the COVID-19 pandemic waves in Germany.
- Cardiovascular diagnoses, including myocardial infarction and heart failure, were less affected, showing no significant increase or decrease.
- Further research is needed to assess potential long-term effects of the pandemic on cardiovascular care access and outcomes.
Background:
In this retrospective routine data analysis, we investigate the number of emergency department (ED) consultations during the COVID-19 pandemic of 2020 in Germany compared to the previous year with a special focus on numbers of myocardial infarction and acute heart failure.
Methods:
Aggregated case numbers for the two consecutive years 2019 and 2020 were obtained from 24 university hospitals and 9 non-university hospitals in Germany and assessed by age, gender, triage scores, disposition, care level and by ICD-10 codes including the tracer diagnoses myocardial infarction (I21) and heart failure (I50).
Results:
A total of 2,216,627 ED consultations were analyzed, of which 1,178,470 occurred in 2019 and 1,038,157 in 2020. The median deviation in case numbers between 2019 and 2020 was - 14% [CI (- 11)-(- 16)]. After a marked drop in all cases in the first COVID-19 wave in spring 2020, case numbers normalized during the summer. Thereafter starting in calendar week 39 case numbers constantly declined until the end of the year 2020. The decline in case numbers predominantly concerned younger [- 16%; CI (- 13)-(- 19)], less urgent [- 18%; CI (- 12)-(- 22)] and non-admitted cases [- 17%; CI (- 13)-(- 20)] in particular during the second wave. During the entire observation period admissions for chest pain [- 13%; CI (- 21)-2], myocardial infarction [- 2%; CI (- 9)-11] and heart failure [- 2%; CI (- 10)-6] were less affected and remained comparable to the previous year.
Conclusions:
ED visits were noticeably reduced during both SARS-CoV-2 pandemic waves in Germany but cardiovascular diagnoses were less affected and no refractory increase was noted. However, long-term effects cannot be ruled out and need to be analysed in future studies.
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