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Published in: Clinical Research in Cardiology 10/2022

Open Access 05-08-2022 | Myocardial Infarction | Original Paper

Medical and cardio-vascular emergency department visits during the COVID-19 pandemic in 2020: is there a collateral damage? A retrospective routine data analysis

Authors: Anna Slagman, Mareen Pigorsch, Felix Greiner, Wilhelm Behringer, Michael Bernhard, Jonas Bienzeisler, Sabine Blaschke, Volker Burst, Katharina Dechant, Michael Dommasch, Sebastian Ewen, André Gries, Felix Patricius Hans, Karl-Georg Kanz, Matthias Klein, Philipp Kümpers, Matthias Napp, Christopher Plata, Alexandra Ramshorn-Zimmer, Joachim Risse, Rainer Röhrig, Rajan Somasundaram, Domagoj Schunk, Felix Walcher, Thomas Walter, Dirk Weismann, Sebastian Wolfrum, Markus Wörnle, Yves Noel Wu, Martin Möckel

Published in: Clinical Research in Cardiology | Issue 10/2022

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Abstract

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.

Graphical abstract

Appendix
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Literature
1.
2.
go back to reference Huang HH et al (2006) Declining emergency department visits and costs during the severe acute respiratory syndrome (SARS) outbreak. J Formos Med Assoc 105(1):31–37CrossRef Huang HH et al (2006) Declining emergency department visits and costs during the severe acute respiratory syndrome (SARS) outbreak. J Formos Med Assoc 105(1):31–37CrossRef
3.
go back to reference Giamello JD et al (2020) The emergency department in the COVID19 era. Who are we missing? Eur J Emerg Med 27(4):305–306CrossRef Giamello JD et al (2020) The emergency department in the COVID19 era. Who are we missing? Eur J Emerg Med 27(4):305–306CrossRef
4.
go back to reference Luceri F et al (2020) Italy and COVID-19: the changing patient flow in an orthopedic trauma center emergency department. J Orthop Surg Res 15(1):323CrossRef Luceri F et al (2020) Italy and COVID-19: the changing patient flow in an orthopedic trauma center emergency department. J Orthop Surg Res 15(1):323CrossRef
5.
go back to reference Maleitzke T et al (2021) Impact of the COVID-19 shutdown on orthopedic trauma numbers and patterns in an academic Level I Trauma Center in Berlin, Germany. PLoS ONE 16(2):e0246956CrossRef Maleitzke T et al (2021) Impact of the COVID-19 shutdown on orthopedic trauma numbers and patterns in an academic Level I Trauma Center in Berlin, Germany. PLoS ONE 16(2):e0246956CrossRef
6.
go back to reference Jeffery MM et al (2020) 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 Intern Med 180(10):1328–1333CrossRef Jeffery MM et al (2020) 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 Intern Med 180(10):1328–1333CrossRef
7.
go back to reference Rennert-May E et al (2021) The impact of COVID-19 on hospital admissions and emergency department visits: a population-based study. PLoS ONE 16(6):e0252441CrossRef Rennert-May E et al (2021) The impact of COVID-19 on hospital admissions and emergency department visits: a population-based study. PLoS ONE 16(6):e0252441CrossRef
8.
go back to reference Hoyer C et al (2020) Acute stroke in times of the COVID-19 pandemic: a multicenter study. Stroke 51(7):2224–2227CrossRef Hoyer C et al (2020) Acute stroke in times of the COVID-19 pandemic: a multicenter study. Stroke 51(7):2224–2227CrossRef
9.
go back to reference Pessoa-Amorim G et al (2020) Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology. Eur Heart J Qual Care Clin Outcomes 6(3):210–216CrossRef Pessoa-Amorim G et al (2020) Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology. Eur Heart J Qual Care Clin Outcomes 6(3):210–216CrossRef
10.
go back to reference De Rosa S et al (2020) Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 41(22):2083–2088CrossRef De Rosa S et al (2020) Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 41(22):2083–2088CrossRef
11.
go back to reference Dreger H et al (2020) Acute myocardial infarction admissions in Berlin during the COVID-19 pandemic. Dtsch Arztebl Int 117(35–36):597–598PubMed Dreger H et al (2020) Acute myocardial infarction admissions in Berlin during the COVID-19 pandemic. Dtsch Arztebl Int 117(35–36):597–598PubMed
12.
go back to reference Metzler B et al (2020) Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 41(19):1852–1853CrossRef Metzler B et al (2020) Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 41(19):1852–1853CrossRef
13.
go back to reference Baldi E et al (2020) COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J 41(32):3045–3054CrossRef Baldi E et al (2020) COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J 41(32):3045–3054CrossRef
14.
go back to reference Elmer J et al (2020) Indirect effects of COVID-19 on OHCA in a low prevalence region. Resuscitation 156:282–283CrossRef Elmer J et al (2020) Indirect effects of COVID-19 on OHCA in a low prevalence region. Resuscitation 156:282–283CrossRef
15.
go back to reference Huber BC et al (2020) Out-of-hospital cardiac arrest incidence during COVID-19 pandemic in Southern Germany. Resuscitation 157:121–122CrossRef Huber BC et al (2020) Out-of-hospital cardiac arrest incidence during COVID-19 pandemic in Southern Germany. Resuscitation 157:121–122CrossRef
16.
go back to reference Jain N et al (2021) Effect of COVID19 on prehospital pronouncements and ED visits for stroke and myocardial infarction. Am J Emerg Med 43:46–49CrossRef Jain N et al (2021) Effect of COVID19 on prehospital pronouncements and ED visits for stroke and myocardial infarction. Am J Emerg Med 43:46–49CrossRef
17.
go back to reference Spaccarotella C, Sorrentino S, Indolfi C (2021) Reduction of hospitalisations and increased mortality for acute coronary syndromes during covid-19 era: not all countries are equal. Lancet Reg Health West Pac 12:100155CrossRef Spaccarotella C, Sorrentino S, Indolfi C (2021) Reduction of hospitalisations and increased mortality for acute coronary syndromes during covid-19 era: not all countries are equal. Lancet Reg Health West Pac 12:100155CrossRef
18.
21.
go back to reference Schilling JBS, Fischer M, Goerlitz L, Grote U, Haas W, Hamouda O, Prahm K, Tolksdorf K (2021) Retrospektive Phaseneinteilung der COVID-19-Pandemie in Deutschland bis Februar 2021. Epid Bull 15:8–17 Schilling JBS, Fischer M, Goerlitz L, Grote U, Haas W, Hamouda O, Prahm K, Tolksdorf K (2021) Retrospektive Phaseneinteilung der COVID-19-Pandemie in Deutschland bis Februar 2021. Epid Bull 15:8–17
22.
go back to reference Morello F et al (2021) After the first wave and beyond lockdown: long-lasting changes in emergency department visit number, characteristics, diagnoses, and hospital admissions. Intern Emerg Med 16(6):1683–1690CrossRef Morello F et al (2021) After the first wave and beyond lockdown: long-lasting changes in emergency department visit number, characteristics, diagnoses, and hospital admissions. Intern Emerg Med 16(6):1683–1690CrossRef
23.
go back to reference Nourazari S et al (2021) Decreased hospital admissions through emergency departments during the COVID-19 pandemic. Am J Emerg Med 42:203–210CrossRef Nourazari S et al (2021) Decreased hospital admissions through emergency departments during the COVID-19 pandemic. Am J Emerg Med 42:203–210CrossRef
24.
go back to reference Venkatesh AK et al (2021) Emergency department utilization for emergency conditions during COVID-19. Ann Emerg Med 78(1):84–91CrossRef Venkatesh AK et al (2021) Emergency department utilization for emergency conditions during COVID-19. Ann Emerg Med 78(1):84–91CrossRef
25.
go back to reference Golinelli D et al (2021) Patterns of emergency department visits for acute and chronic diseases during the two pandemic waves in Italy. Am J Emerg Med 50:22–26CrossRef Golinelli D et al (2021) Patterns of emergency department visits for acute and chronic diseases during the two pandemic waves in Italy. Am J Emerg Med 50:22–26CrossRef
26.
go back to reference Mafham MM et al (2020) COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet 396(10248):381–389CrossRef Mafham MM et al (2020) COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet 396(10248):381–389CrossRef
27.
go back to reference Mesnier J et al (2020) Hospital admissions for acute myocardial infarction before and after lockdown according to regional prevalence of COVID-19 and patient profile in France: a registry study. Lancet Public Health 5(10):e536–e542CrossRef Mesnier J et al (2020) Hospital admissions for acute myocardial infarction before and after lockdown according to regional prevalence of COVID-19 and patient profile in France: a registry study. Lancet Public Health 5(10):e536–e542CrossRef
28.
go back to reference Olie V et al (2021) Emergency department admissions for myocardial infarction and stroke in France during the first wave of the COVID-19 pandemic: national temporal trends and regional disparities. Arch Cardiovasc Dis 114(5):371–380CrossRef Olie V et al (2021) Emergency department admissions for myocardial infarction and stroke in France during the first wave of the COVID-19 pandemic: national temporal trends and regional disparities. Arch Cardiovasc Dis 114(5):371–380CrossRef
29.
go back to reference Van Belle E et al (2021) Myocardial Infarction incidence during national lockdown in two French provinces unevenly affected by COVID-19 outbreak: an observational study. Lancet Reg Health Eur 2:100030CrossRef Van Belle E et al (2021) Myocardial Infarction incidence during national lockdown in two French provinces unevenly affected by COVID-19 outbreak: an observational study. Lancet Reg Health Eur 2:100030CrossRef
30.
go back to reference Marijon E et al (2020) Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. Lancet Public Health 5(8):e437–e443CrossRef Marijon E et al (2020) Out-of-hospital cardiac arrest during the COVID-19 pandemic in Paris, France: a population-based, observational study. Lancet Public Health 5(8):e437–e443CrossRef
31.
go back to reference Nab M et al (2021) Delayed emergency healthcare seeking behaviour by Dutch emergency department visitors during the first COVID-19 wave: a mixed methods retrospective observational study. BMC Emerg Med 21(1):56CrossRef Nab M et al (2021) Delayed emergency healthcare seeking behaviour by Dutch emergency department visitors during the first COVID-19 wave: a mixed methods retrospective observational study. BMC Emerg Med 21(1):56CrossRef
32.
go back to reference Santi L et al (2021) Non-COVID-19 patients in times of pandemic: Emergency department visits, hospitalizations and cause-specific mortality in Northern Italy. PLoS ONE 16(3):e0248995CrossRef Santi L et al (2021) Non-COVID-19 patients in times of pandemic: Emergency department visits, hospitalizations and cause-specific mortality in Northern Italy. PLoS ONE 16(3):e0248995CrossRef
33.
go back to reference Naqvi HR et al (2021) Improved air quality and associated mortalities in India under COVID-19 lockdown. Environ Pollut 268(Pt A):115691CrossRef Naqvi HR et al (2021) Improved air quality and associated mortalities in India under COVID-19 lockdown. Environ Pollut 268(Pt A):115691CrossRef
35.
go back to reference Karagiannidis C et al (2021) Major differences in ICU admissions during the first and second COVID-19 wave in Germany. Lancet Respir Med 9(5):e47–e48CrossRef Karagiannidis C et al (2021) Major differences in ICU admissions during the first and second COVID-19 wave in Germany. Lancet Respir Med 9(5):e47–e48CrossRef
Metadata
Title
Medical and cardio-vascular emergency department visits during the COVID-19 pandemic in 2020: is there a collateral damage? A retrospective routine data analysis
Authors
Anna Slagman
Mareen Pigorsch
Felix Greiner
Wilhelm Behringer
Michael Bernhard
Jonas Bienzeisler
Sabine Blaschke
Volker Burst
Katharina Dechant
Michael Dommasch
Sebastian Ewen
André Gries
Felix Patricius Hans
Karl-Georg Kanz
Matthias Klein
Philipp Kümpers
Matthias Napp
Christopher Plata
Alexandra Ramshorn-Zimmer
Joachim Risse
Rainer Röhrig
Rajan Somasundaram
Domagoj Schunk
Felix Walcher
Thomas Walter
Dirk Weismann
Sebastian Wolfrum
Markus Wörnle
Yves Noel Wu
Martin Möckel
Publication date
05-08-2022
Publisher
Springer Berlin Heidelberg
Published in
Clinical Research in Cardiology / Issue 10/2022
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-022-02074-3

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