How SARS-CoV-2 pandemic changed medical emergency calls: a journey among virus effects and people's fears in Italy

ABSTRACT

Purpose of the study Coronavirus disease 2019 (COVID-19) has caused severe morbidity and mortality around the world. As a consequence, emergency calls have increased worldwide. Emergency services in Italy are coordinated by 118 Operation Centres (118-OC). This study analizes newtendencies in emergency calls received by 118- OC in Foggia University Hospital, covering the whole Province of Foggia and beyond, about 650,000 inhabitants. Materials and methods:We analized all emergency calls received by our 118-OC during the second half of 2020, corresponding to the second wave of COVID-19, when emergency services and hospitals were better prepared than the first wave. A similar period was chosen before pandemic, from July to December 2019, as control. R statistical software was used for analysis and chi-squared tests were performed to compare frequencies. Results: The increase in emergency calls in 2020 immediately stands out (p-value < 0.00001). However, in 2020 there was a statistically significant increase in “non-emergencies” and a decrease in “emergencies” (p-value < 0.00001). The decrease in overall emergencies was not proportional to all types of emergencies. Evaluating cardiocirculatory emergencies compared to non-cardiovascular ones, the former decreased much more than the others (p-value < 0.00001). Ultimately, a traumatic event was more likely to activate “118” than a cardiovascular event compared to pre-COVID times. Nevertheless, this decrease in cardiocirculatory emergencies was not accompanied by a decrease in STEMI, which were more numerous than expected (pvalue < 0.0001). Conclusions: COVID pandemic caused a decrease in real emergency calls, probably due to the fear of activating “118” even on the part of those who needed it. The suspicion of many cardiovascular diagnoses that have not been observed is conceivable. Moreover, our results show that in 2020 there were more cardiocirculatory events with STEMI than expected. Perhaps we need to recognize a linkbetween SARS-CoV-2 and acute coronary syndrome, as literature is beginning to hypothesize