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1.
Infect Control Hosp Epidemiol ; 42(1): 89-92, 2021 01.
Article in English | MEDLINE | ID: covidwho-2096391
3.
J Clin Psychiatry ; 82(2)2021 Mar 16.
Article in English | MEDLINE | ID: covidwho-2066787

ABSTRACT

BACKGROUND: Most research evaluating telehealth psychiatric treatment has been conducted in outpatient settings. There is a great lack of research assessing the efficacy of telehealth treatment in more acute, intensive treatment settings such as a partial hospital. In the face of the COVID-19 pandemic, much of behavioral health treatment has transitioned to a virtual format. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined the effectiveness of our partial hospital program (PHP). METHOD: The sample included 207 patients who were treated virtually from May 2020 to September 2020 and a comparison group of 207 patients who were treated in the in-person partial program a year earlier. Patients completed self-administered measures of patient satisfaction, symptoms, coping ability, functioning, and general well-being. RESULTS: For both the in-person and telehealth methods of delivering partial hospital level of care, patients were highly satisfied with treatment and reported a significant reduction in symptoms and suicidality from admission to discharge. On the modified Remission from Depression Questionnaire, the primary outcome measure, both groups reported a significant (P < .01) improvement in functioning, coping ability, positive mental health, and general well-being. A large effect size of treatment (Cohen d > 0.8) was found in both treatment groups. The only significant difference in outcome between the patients treated in the different formats was a greater length of stay (mean ± SD of 13.5 ± 8.1 vs 8.5 ± 5.0 days, t = 7.61, P < .001) and greater likelihood of staying in treatment until completion (72.9% vs 62.3%, χ2 = 5.34, P < .05) in the virtually treated patients. CONCLUSIONS: Telehealth partial hospital treatment was as effective as in-person treatment in terms of patient satisfaction, symptom reduction, suicidal ideation reduction, and improved functioning and well-being. The treatment completion rate was higher in the telehealth cohort, and several patients who were treated virtually commented that they never would have presented for in-person treatment even if there was no pandemic. Telehealth PHPs should be considered a viable treatment option even after the pandemic has resolved.


Subject(s)
Behavior Therapy , COVID-19 , Emergency Services, Psychiatric , Mental Disorders , Telemedicine , Adult , Behavior Therapy/methods , Behavior Therapy/trends , COVID-19/epidemiology , COVID-19/prevention & control , Emergency Service, Hospital/statistics & numerical data , Emergency Services, Psychiatric/methods , Emergency Services, Psychiatric/trends , Female , Hospitalization/statistics & numerical data , Humans , Infection Control/methods , Male , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Mental Disorders/therapy , Mental Health/trends , Patient Safety , Patient Satisfaction , SARS-CoV-2 , Telemedicine/methods , Telemedicine/organization & administration , United States/epidemiology
6.
Am J Emerg Med ; 51: 262-266, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1827781

ABSTRACT

IMPORTANCE: Considering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic. OBJECTIVE: To identify the incidence and sociodemographic characteristics of self-harm and violence during the COVID19 lockdown and compare with a control group from the previous year. DESIGN: A cross-sectional retrospective observational study. SETTING: Tertiary care teaching hospital. PARTICIPANTS: All patients presenting to the emergency department (ED) with self harm and violence during the COVID-19 lockdown period between March 24-June 30, 2020 and March 24-June 30, 2019. EXPOSURE: The COVID-19 lockdown period. MAIN OUTCOME (S) AND MEASURE (S): The hypothesis being tested was formulated before the study. The null hypothesis tested was a decline in number of self-harm and violence cases during the lockdown. RESULTS: A total of 828 patients were analysed over both the time periods, out of which 30% (248) were females while 70% (580) were males. Increases in self-harm and violence were 12.71% and 95.32% respectively per 1000 ED admissions. A significant correlation was found between the COVID-19 lockdown and the increased incidence (X2 (1, N = 828) = 9.2, p < .05). An increase of violence by known individuals and between partners was seen. Intimate partner violence also increased to 7%. X2 (3, N = 662) = 21.03, p < .05. In the self harm dataset an increase in mortality, ICU admissions and decision to leave against medical advice was noted (X2 (4, N = 166) = 24.49, p < .05). Increase in the use of alcohol prior to acts of self harm and violence was noted. CONCLUSIONS: Increase in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner. TRIAL REGISTRATION: N/A.


Subject(s)
COVID-19/epidemiology , Self-Injurious Behavior/epidemiology , Violence/statistics & numerical data , Adult , Communicable Disease Control , Cross-Sectional Studies , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization , Humans , Incidence , India/epidemiology , Intimate Partner Violence , Male , Middle Aged , Pandemics , Retrospective Studies , Young Adult
7.
West J Emerg Med ; 22(6): 1257-1261, 2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1761084

ABSTRACT

INTRODUCTION: Patients diagnosed with coronavirus disease 2019 (COVID-19) require significant healthcare resources. While published research has shown clinical characteristics associated with severe illness from COVID-19, there is limited data focused on the emergency department (ED) discharge population. METHODS: We performed a retrospective chart review of all ED-discharged patients from Wake Forest Baptist Health and Wake Forest Baptist Health Davie Medical Center between April 25-August 9, 2020, who tested positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from a nasopharyngeal swab using real-time reverse transcription polymerase chain reaction (rRT-PCR) tests. We compared the clinical characteristics of patients who were discharged and had return visits within 30 days to those patients who did not return to the ED within 30 days. RESULTS: Our study included 235 adult patients who had an ED-performed SARS-CoV-2 rRT-PCR positive test and were subsequently discharged on their first ED visit. Of these patients, 57 (24.3%) had return visits to the ED within 30 days for symptoms related to COVID-19. Of these 57 patients, on return ED visits 27 were admitted to the hospital and 30 were not admitted. Of the 235 adult patients who were discharged, 11.5% (27) eventually required admission for COVID-19-related symptoms. With 24.3% patients having a return ED visit after a positive SARS-CoV-2 test and 11.5% requiring eventual admission, it is important to understand clinical characteristics associated with return ED visits. We performed multivariate logistic regression analysis of the clinical characteristics with independent association resulting in a return ED visit, which demonstrated the following: diabetes (odds ratio [OR] 2.990, 95% confidence interval [CI, 1.21-7.40, P = 0.0179); transaminitis (OR 8.973, 95% CI, 2.65-30.33, P = 0.004); increased pulse at triage (OR 1.04, 95% CI, 1.02-1.07, P = 0.0002); and myalgia (OR 4.43, 95% CI, 2.03-9.66, P = 0.0002). CONCLUSION: As EDs across the country continue to treat COVID-19 patients, it is important to understand the clinical factors associated with ED return visits related to SARS-CoV-2 infection. We identified key clinical characteristics associated with return ED visits for patients initially diagnosed with SARS-CoV-2 infection: diabetes mellitus; increased pulse at triage; transaminitis; and complaint of myalgias.


Subject(s)
COVID-19/diagnosis , Emergency Service, Hospital/statistics & numerical data , Patient Discharge , Patient Readmission , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 Nucleic Acid Testing , COVID-19 Testing , Humans , Middle Aged , Retrospective Studies , SARS-CoV-2/genetics
8.
West J Emerg Med ; 22(6): 1262-1269, 2021 Oct 26.
Article in English | MEDLINE | ID: covidwho-1761083

ABSTRACT

INTRODUCTION: Coinfection with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and another virus may influence the clinical trajectory of emergency department (ED) patients. However, little empirical data exists on the clinical outcomes of coinfection with SARS-CoV-2 METHODS: In this retrospective cohort analysis, we included adults presenting to the ED with confirmed, symptomatic coronavirus 2019 who also underwent testing for additional viral pathogens within 24 hours. To investigate the association between coinfection status with each of the outcomes, we performed logistic regression. RESULTS: Of 6,913 ED patients, 5.7% had coinfection. Coinfected individuals were less likely to experience index visit or 30-day hospitalization (odds ratio [OR] 0.57; 95% confidence interval [CI], 0.36-0.90 and OR 0.39; 95% CI, 0.25-0.62, respectively). CONCLUSION: Coinfection is relatively uncommon in symptomatic ED patients with SARS-CoV-2 and the clinical short- and long-term outcomes are more favorable in coinfected individuals.


Subject(s)
COVID-19/therapy , Coinfection/virology , Emergency Service, Hospital/statistics & numerical data , Hospitalization/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/mortality , Coinfection/epidemiology , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index
11.
Clin Pediatr (Phila) ; 61(2): 206-211, 2022 02.
Article in English | MEDLINE | ID: covidwho-1736198

ABSTRACT

To better understand the impact of prenatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on infants, this study sought to compare the risk of hospital visits and of postnatal SARS-CoV-2 infection between infants born to mothers with and without prenatal SARS-CoV-2 infection. In this retrospective observational cohort study of 6871 mothers and their infants, overall rates of emergency department (ED) visits and hospital admissions in the first 90 days of life were similar for infants born to mothers with and without prenatal SARS-CoV-2 infection. Infants born to negative mothers were more likely than infants of positive mothers to be hospitalized after ED visit (relative risk: 3.76; 95% confidence interval: 1.27-11.13, P = .003). Five infants tested positive; all were born to negative mothers, suggesting that maternal prenatal SARS-CoV-2 infection may protect infants from postnatal infection. The lower acuity ED visits for infants born to mothers with prenatal SARS-CoV-2 infection may reflect a heightened level of concern among these mothers.


Subject(s)
COVID-19/complications , Emergency Service, Hospital/statistics & numerical data , Hospitalization/statistics & numerical data , Pregnancy Complications, Infectious/diagnosis , Adult , COVID-19/epidemiology , Cohort Studies , Emergency Service, Hospital/organization & administration , Female , Humans , Infant , Infant, Newborn , Male , New York City/epidemiology , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Retrospective Studies
12.
Acta Orthop ; 93: 360-366, 2022 03 07.
Article in English | MEDLINE | ID: covidwho-1731698

ABSTRACT

BACKGROUND AND PURPOSE: COVID-19 lockdowns have affected personal mobility and behavior worldwide. This study compared the number of emergency department (ED) visits due to injuries and typical low-energy fractures in Finland during the COVID-19 lockdown period in spring 2020 to the reference period in 2019. PATIENTS AND METHODS: The data was collected retrospectively from the electronic patient records of 4 hospitals covering 1/5 of the Finnish population. We included the patients who were admitted to a hospital ED due to any injury during the lockdown period (March 18-May 31, 2020) and the reference period (March 18-May 31, 2019). We compared the differences between the average daily ED admissions in the 2 years using the zero-inflated Poisson regression model. RESULTS: The overall number of ED visits due to injuries decreased by 16% (mean 134/day vs. 113/day, 95% CI -18 to -13). The number of ED visits due to wrist fractures decreased among women aged over 50 years by 40% (CI -59 to -9). Among women, the number of ED visits due to ankle fractures decreased by 32% (CI -52 to -5). The number of ED visits due to fractures of the upper end of the humerus decreased by 52% (CI -71 to -22) among women. The number of ED visits due to hip fractures increased by 2% (CI -16 to 24). INTERPRETATION: Restrictions in personal mobility decreased the number of ED visits due to injuries during the pandemic. The effect can mainly be seen as a decreased number of the most typical low-energy fractures among women. In contrast, lockdown restrictions had no effect on the number of hip fractures.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/methods , Emergency Service, Hospital/statistics & numerical data , Hip Fractures/epidemiology , Hospitalization/trends , Quarantine , SARS-CoV-2 , Adolescent , Adult , COVID-19/transmission , Comorbidity , Female , Finland/epidemiology , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Pandemics , Retrospective Studies , Young Adult
13.
MMWR Morb Mortal Wkly Rep ; 71(9): 352-358, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1727017

ABSTRACT

The efficacy of the BNT162b2 (Pfizer-BioNTech) vaccine against laboratory-confirmed COVID-19 exceeded 90% in clinical trials that included children and adolescents aged 5-11, 12-15, and 16-17 years (1-3). Limited real-world data on 2-dose mRNA vaccine effectiveness (VE) in persons aged 12-17 years (referred to as adolescents in this report) have also indicated high levels of protection against SARS-CoV-2 (the virus that causes COVID-19) infection and COVID-19-associated hospitalization (4-6); however, data on VE against the SARS-CoV-2 B.1.1.529 (Omicron) variant and duration of protection are limited. Pfizer-BioNTech VE data are not available for children aged 5-11 years. In partnership with CDC, the VISION Network* examined 39,217 emergency department (ED) and urgent care (UC) encounters and 1,699 hospitalizations† among persons aged 5-17 years with COVID-19-like illness across 10 states during April 9, 2021-January 29, 2022,§ to estimate VE using a case-control test-negative design. Among children aged 5-11 years, VE against laboratory-confirmed COVID-19-associated ED and UC encounters 14-67 days after dose 2 (the longest interval after dose 2 in this age group) was 46%. Among adolescents aged 12-15 and 16-17 years, VE 14-149 days after dose 2 was 83% and 76%, respectively; VE ≥150 days after dose 2 was 38% and 46%, respectively. Among adolescents aged 16-17 years, VE increased to 86% ≥7 days after dose 3 (booster dose). VE against COVID-19-associated ED and UC encounters was substantially lower during the Omicron predominant period than the B.1.617.2 (Delta) predominant period among adolescents aged 12-17 years, with no significant protection ≥150 days after dose 2 during Omicron predominance. However, in adolescents aged 16-17 years, VE during the Omicron predominant period increased to 81% ≥7 days after a third booster dose. During the full study period, including pre-Delta, Delta, and Omicron predominant periods, VE against laboratory-confirmed COVID-19-associated hospitalization among children aged 5-11 years was 74% 14-67 days after dose 2, with wide CIs that included zero. Among adolescents aged 12-15 and 16-17 years, VE 14-149 days after dose 2 was 92% and 94%, respectively; VE ≥150 days after dose 2 was 73% and 88%, respectively. All eligible children and adolescents should remain up to date with recommended COVID-19 vaccinations, including a booster dose for those aged 12-17 years.


Subject(s)
/administration & dosage , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , SARS-CoV-2/immunology , /statistics & numerical data , Adolescent , Ambulatory Care/statistics & numerical data , Child , Child, Preschool , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Humans , Immunization, Secondary , Male , United States
14.
Medicine (Baltimore) ; 101(8): e29009, 2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1713784

ABSTRACT

ABSTRACT: The purpose of analyzing changes in the use of emergency departments (EDs) was to better understand how to use ED resources efficiently during infectious disease outbreaks.Our study was a retrospective observational study. We analyzed the patterns of visits of adult and pediatric patients to separate EDs during 2020 coronavirus disease 2019 (COVID-19) outbreak to know the changes in the ED utilization. We collected the patient's demographics and time of visit, patients' acuity level at triage, cause of visit, transportation used, disposition, symptom to visit time, length of stay, and top 10 most common complaints. We compared pediatric and adult EDs before and after COVID-19.The total number of patients who visited the EDs was 197,152 over 3 years. During the COVID-19 outbreak in 2020, the number of visits decreased significantly, especially the number of pediatric patients. The number of ED visits decreased in correlation with a surge in the number of confirmed COVID patients. The proportion of severe cases in pediatric emergency department (PED) visits increased, but there was no difference in adult emergency department. The number of hospitalized PED patients increased, and the number of hospitalized adult emergency department patients decreased. However, both types of ED patients increased in intensive care unit hospitalizations, proportion of deaths, and use of ambulances. The proportion of trauma patients in the PED increased significantly (P  < .001). The time from symptom onset to ED visit time was reduced for patients. The ED length of stay increased in adults, and decreased for pediatric patients.COVID-19 brought about many changes to ED utilization. A greater reduction in ED utilization occurred in pediatric patients compared to adult patients. Our study showed changes in the number and characteristics of patients visiting the ED during the COVID-19 period compared to 2018 and 2019.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Pandemics , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Emergency Service, Hospital/organization & administration , Humans , Middle Aged , Republic of Korea/epidemiology , Retrospective Studies , SARS-CoV-2 , Young Adult
15.
MMWR Morb Mortal Wkly Rep ; 71(8): 313-318, 2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1702098

ABSTRACT

Emergency departments (EDs) in the United States remain a frontline resource for pediatric health care emergencies during the COVID-19 pandemic; however, patterns of health-seeking behavior have changed during the pandemic (1,2). CDC examined changes in U.S. ED visit trends to assess the continued impact of the pandemic on visits among children and adolescents aged 0-17 years (pediatric ED visits). Compared with 2019, pediatric ED visits declined by 51% during 2020, 22% during 2021, and 23% during January 2022. Although visits for non-COVID-19 respiratory illnesses mostly declined, the proportion of visits for some respiratory conditions increased during January 2022 compared with 2019. Weekly number and proportion of ED visits increased for certain types of injuries (e.g., drug poisonings, self-harm, and firearm injuries) and some chronic diseases, with variation by pandemic year and age group. Visits related to behavioral concerns increased across pandemic years, particularly among older children and adolescents. Health care providers and families should remain vigilant for potential indirect impacts of the COVID-19 pandemic, including health conditions resulting from delayed care, and increasing emotional distress and behavioral health concerns among children and adolescents.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Emergency Treatment/classification , Facilities and Services Utilization/statistics & numerical data , Facilities and Services Utilization/trends , Adolescent , Age Distribution , COVID-19/epidemiology , Child , Child, Preschool , Female , Humans , Infant , Male , SARS-CoV-2 , Sentinel Surveillance , United States
16.
MMWR Morb Mortal Wkly Rep ; 71(8): 319-324, 2022 Feb 25.
Article in English | MEDLINE | ID: covidwho-1702097

ABSTRACT

In 2021, a national emergency* for children's mental health was declared by several pediatric health organizations, and the U.S. Surgeon General released an advisory† on mental health among youths. These actions resulted from ongoing concerns about children's mental health in the United States, which was exacerbated by the COVID-19 pandemic (1,2). During March-October 2020, among all emergency department (ED) visits, the proportion of mental health-related visits increased by 24% among U.S. children aged 5-11 years and 31% among adolescents aged 12-17 years, compared with 2019 (2). CDC examined changes in U.S. pediatric ED visits for overall mental health conditions (MHCs) and ED visits associated with specific MHCs (depression; anxiety; disruptive behavioral and impulse-control disorders; attention-deficit/hyperactivity disorder; trauma and stressor-related disorders; bipolar disorders; eating disorders; tic disorders; and obsessive-compulsive disorders [OCD]) during 2019 through January 2022 among children and adolescents aged 0-17 years, overall and by sex and age. After declines in weekly visits associated with MHCs among those aged 0-17 years during 2020, weekly numbers of ED visits for MHCs overall and for specific MHCs varied by age and sex during 2021 and January 2022, when compared with corresponding weeks in 2019. Among adolescent females aged 12-17 years, weekly visits increased for two of nine MHCs during 2020 (eating disorders and tic disorders), for four of nine MHCs during 2021 (depression, eating disorders, tic disorders, and OCD), and for five of nine MHCs during January 2022 (anxiety, trauma and stressor-related disorders, eating disorders, tic disorders, and OCD), and overall MHC visits during January 2022, compared with 2019. Early identification and expanded evidence-based prevention and intervention strategies are critical to improving children's and adolescents' mental health (1-3), especially among adolescent females, who might have increased need.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Emergency Treatment/trends , Facilities and Services Utilization/trends , Mental Disorders/psychology , Mental Health , Adolescent , Age Distribution , COVID-19/epidemiology , Child , Child, Preschool , Female , Humans , Infant , Male , Mental Disorders/classification , SARS-CoV-2 , Sentinel Surveillance , Sex Distribution , United States/epidemiology
17.
Arch Dis Child ; 107(3): e14, 2022 03.
Article in English | MEDLINE | ID: covidwho-1691374

ABSTRACT

OBJECTIVE: To determine the feasibility and impact of having paediatric clinicians working in the Clinical Assessment Services (CAS) within NHS 111, a national telephone advice service. DESIGN: Observational study. SETTING: Six NHS 111 providers across England with CAS where volunteer paediatric clinicians (doctors and advanced nurse practitioners (ANPs)) worked between May and December 2020. A data reporting framework was used to compare the outcomes of calls taken by paediatric vs non-paediatric clinicians. PATIENTS: Under 16-year-olds prompting calls to NHS 111 over the study period. MAIN OUTCOME MEASURES: The disposition (final outcome of calls) taken by paediatric versus non-paediatric clinicians, paediatric clinicians' and patient experience. RESULTS: 70 paediatric clinicians (66 doctors and 4 ANPs) worked flexible shifts in six NHS 111 providers' CAS over the study period: 2535 calls for under 16-year-olds were taken by paediatric clinicians and 137 008 by non-paediatric clinicians. Overall, disposition rates differed significantly between the calls taken by paediatric versus (vs) non-paediatric clinicians: 69% vs 43% were advised on self-care only, 13% vs 18% to attend emergency departments (EDs), 13% vs 29% to attend primary care, 1% vs 4% to receive an urgent ambulance call out and 4% vs 6% referred to another health service, respectively. When compared with recent (all age) national whole data sets, the feedback from calls taken by paediatricians noted a greater proportion of patients/carers reporting that their problem was fully resolved (92% vs 27%). CONCLUSIONS: Introducing paediatric specialists into NHS 111 CAS is likely to increase self-care dispositions, and reduce onward referrals to primary care, ED and ambulances. Future work will evaluate the impact of a national paediatric clinical assessment service to which specific case types are streamed.


Subject(s)
Health Personnel , Pediatrics/methods , Remote Consultation/methods , Telephone , Adolescent , Ambulances/statistics & numerical data , Ambulatory Care Facilities/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , England , Humans , Physicians , Pilot Projects , Primary Health Care/statistics & numerical data , Referral and Consultation/statistics & numerical data , State Medicine , Surveys and Questionnaires , Triage/methods
18.
J Clin Lab Anal ; 36(3): e24264, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1653267

ABSTRACT

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.


Subject(s)
COVID-19/epidemiology , Emergency Service, Hospital/statistics & numerical data , Resuscitation/statistics & numerical data , Adult , Aged , China , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2
19.
Viruses ; 14(2)2022 01 20.
Article in English | MEDLINE | ID: covidwho-1651035

ABSTRACT

BACKGROUND: Previous studies examining the early spread of COVID-19 have used influenza-like illnesses (ILIs) to determine the early spread of COVID-19. We used COVID-19 case definition to identify COVID-like symptoms (CLS) independently of other influenza-like illnesses (ILIs). METHODS: Using data from Emergency Department (ED) visits at VA Medical Centers in CA, TX, and FL, we compared weekly rates of CLS, ILIs, and non-influenza ILIs encounters during five consecutive flu seasons (2015-2020) and estimated the risk of developing each illness during the first 23 weeks of the 2019-2020 season compared to previous seasons. RESULTS: Patients with CLS were significantly more likely to visit the ED during the first 23 weeks of the 2019-2020 compared to prior seasons, while ED visits for influenza and non-influenza ILIs did not differ substantially. Adjusted CLS risk was significantly lower for all seasons relative to the 2019-2020 season: RR15-16 = 0.72, 0.75, 0.72; RR16-17 = 0.81, 0.77, 0.79; RR17-18 = 0.80, 0.89, 0.83; RR18-19 = 0.82, 0.96, 0.81, in CA, TX, and FL, respectively. CONCLUSIONS: The observed increase in ED visits for CLS indicates the likely spread of COVID-19 in the US earlier than previously reported. VA data could potentially help identify emerging infectious diseases and supplement existing syndromic surveillance systems.


Subject(s)
COVID-19/transmission , Databases, Factual/statistics & numerical data , Influenza, Human/epidemiology , Sentinel Surveillance , Veterans/statistics & numerical data , COVID-19/epidemiology , Disease Outbreaks , Emergency Service, Hospital/statistics & numerical data , Humans , Longitudinal Studies , Retrospective Studies , United States/epidemiology
20.
BMJ ; 376: e066809, 2022 01 17.
Article in English | MEDLINE | ID: covidwho-1627540

ABSTRACT

OBJECTIVES: To explore whether and for how long use of healthcare services is increased among children and adolescents after covid-19. DESIGN: Before and after register based study. SETTING: General population of Norway. PARTICIPANTS: Norwegians aged 1-19 years (n=706 885) who were tested for SARS-CoV-2 from 1 August 2020 to 1 February 2021 (n=10 279 positive, n=275 859 negative) or not tested (n=420 747) and were not admitted to hospital, by age groups 1-5, 6-15, and 16-19 years. MAIN OUTCOME MEASURES: Monthly percentages of all cause and cause specific healthcare use in primary care (general practitioner, emergency ward) and specialist care (outpatient, inpatient) from six months before to about six months after the week of being tested for SARS-CoV-2, using a difference-in-differences approach. RESULTS: A substantial short term relative increase in primary care use was observed for participants during the first month after a positive SARS-CoV-2 test result compared with those who tested negative (age 1-5 years: 339%, 95% confidence interval 308% to 369%; 6-15 years: 471%, 450% to 491%; 16-19 years: 401%, 380% to 422%). Use of primary care for the younger age groups was still increased at two months (1-5 years: 22%, 4% to 40%; 6-15 years: 14%, 2% to 26%) and three months (1-5 years: 26%, 7% to 46%, 6-15 years: 15%, 3% to 28%), but not for the oldest group (16-19 years: 11%, -2% to 24% and 6%, -7% to 19%, respectively). Children aged 1-5 years who tested positive also showed a minor long term (≤6 months) relative increase in primary care use (13%, -0% to 26%) that was not observed for the older age groups, compared with same aged children who tested negative. Results were similar yet the age differences less pronounced compared with untested controls. For all age groups, the increase in primary care visits was due to respiratory and general or unspecified conditions. No increased use of specialist care was observed. CONCLUSION: Covid-19 among children and adolescents was found to have limited impact on healthcare services in Norway. Preschool aged children might take longer to recover (3-6 months) than primary or secondary school students (1-3 months), usually because of respiratory conditions.


Subject(s)
COVID-19/diagnosis , COVID-19/therapy , Facilities and Services Utilization , Primary Health Care/statistics & numerical data , Adolescent , Age Factors , Ambulatory Care/statistics & numerical data , COVID-19/complications , COVID-19 Nucleic Acid Testing , Child , Child, Preschool , Cohort Studies , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization/statistics & numerical data , Humans , Infant , Male , Norway , Pandemics , Registries , SARS-CoV-2 , Severity of Illness Index , Time Factors
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