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Non-COVID-19 patients in times of pandemic: decreased emergency department visits and increased out-of-hospital mortality in Northern Italy
Luca Santi; Davide Golinelli; Andrea Tampieri; Gabriele Farina; Manfredi Greco; Simona Rosa; Michelle Beleffi; Bianca Biavati; Francesca Campinoti; Stefania Guerrini; Rodolfo Ferrari; Paola Rucci; Maria Pia Fantini; Fabrizio Giostra.
  • Luca Santi; Policlinico S. Orsola Malpighi. Dipartimento dell Emergenza Urgenza. Unita operativa di Medicina d urgenza e Pronto Soccorso. Via Giuseppe Massarenti, 9, 40138,
  • Davide Golinelli; University of Bologna
  • Andrea Tampieri; Ospedale S. Maria della Scaletta. Dipartimento di Emergenza urgenza e Accettazione. Unita Operativa di Pronto Soccorso e Medicina d Urgenza. Viale Amendola, 2,
  • Gabriele Farina; Policlinico S. Orsola-Malpighi. Dipartimento dell Emergenza Urgenza. Unita operativa di Medicina d urgenza e Pronto Soccorso. Via Giuseppe Massarenti, 9, 40138,
  • Manfredi Greco; Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum University of Bologna. Via San Giacomo 12, 40126, Bologna, Italy.
  • Simona Rosa; Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum. University of Bologna. Via San Giacomo 12, 40126, Bologna, Italy.
  • Michelle Beleffi; Alma Mater Studiorum. University of Bologna. Via Zamboni, 33, 40126 Bologna, Italy.
  • Bianca Biavati; Alma Mater Studiorum, University of Bologna. Via Zamboni, 33, 40126 Bologna, Italy.
  • Francesca Campinoti; Alma Mater Studiorum, University of Bologna. Via Zamboni, 33, 40126 Bologna, Italy.
  • Stefania Guerrini; Policlinico S. Orsola Malpighi. Dipartimento dell Emergenza Urgenza. Unita operativa di Medicina d urgenza e Pronto Soccorso. Via Giuseppe Massarenti, 9, 40138,
  • Rodolfo Ferrari; Ospedale S. Maria della Scaletta. Dipartimento di Emergenza urgenza e Accettazione. Unita Operativa di Pronto Soccorso e Medicina d Urgenza. Viale Amendola, 2,
  • Paola Rucci; Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum, University of Bologna. Via San Giacomo 12, 40126, Bologna, Italy.
  • Maria Pia Fantini; Dipartimento di Scienze Biomediche e Neuromotorie, Alma Mater Studiorum, University of Bologna. Via San Giacomo 12, 40126, Bologna, Italy.
  • Fabrizio Giostra; Policlinico S. Orsola-Malpighi. Dipartimento dell Emergenza Urgenza. Unita operativa di Medicina d urgenza e Pronto Soccorso. Via Giuseppe Massarenti, 9, 40138,
Preprint in English | medRxiv | ID: ppmedrxiv-20229237
ABSTRACT
ObjectiveThe aim of this was to assess the short-term impact of the pandemic on non-COVID-19 patients living in a one-million inhabitants area in Northern Italy (Bologna Metropolitan Area-BMA), analyzing time trends of Emergency Department (ED) visits, hospitalizations and mortality. MethodsWe conducted a retrospective observational study using data extracted from BMA healthcare informative systems. Weekly trends of ED visits, hospitalizations, in- and out-of-hospital, all-cause and cause-specific mortality between December 1st, 2019 to May 31st, 2020, were compared with those of the same period of the previous year, using Joinpoint regression models and incidence rate ratios. ResultsNon-COVID-19 ED visits and hospitalizations showed a stable trend until the first Italian case of COVID-19 has been recorded, on February 19th, 2020, when they dropped simultaneously. The reduction of ED visits was observed in all age groups and across all severity and diagnosis groups. In the lockdown period a significant increase was found in overall out-of-hospital mortality (43.2%) and cause-specific out-of-hospital mortality related to neoplasms (76.7%), endocrine, nutritional and metabolic (79.5%) as well as cardiovascular (32.7%) diseases. ConclusionsThe pandemic caused a sudden drop of ED visits and hospitalizations of non-COVID-19 patients during the lockdown period, and a concurrent increase in out-of-hospital mortality mainly driven by deaths for neoplasms, cardiovascular and endocrine diseases. The findings of this study might be useful to understand both the population reaction and the healthcare system response at the early phases of the pandemic in terms of reduced demand of care and systems capability in intercepting it.
Full text: Available Collection: Preprints Database: medRxiv Type of study: Prognostic study / Randomized controlled trials Language: English Year: 2020 Document Type: Preprint

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Full text: Available Collection: Preprints Database: medRxiv Type of study: Prognostic study / Randomized controlled trials Language: English Year: 2020 Document Type: Preprint