Impact of the COVID-19 Epidemic on the Routine Emergency Services in a Tertiary Hospital, China: A Retrospective Cohort Study

Background: The sudden outbreak of COVID-19 epidemic in China has caused tremendous challenges on the Chineses medical system. The Chinese government and hospitals have taken robust measures to curb the spread of the deadly virus. Its impact on the routine medical services was ignored and nil-discussed. Objective: To identify the impact of the novel coronavirus epidemic on emergency department (ED) patient flow and safety, and the performance of the routine ED service. Methods: This retrospective observational cohort study was undertaken in a tertiary public teaching hospital ED in Chengdu, China. ED data of patients were routinely collected to compare demographic, clinical characteristics, and outcomes around the Chinese New Year Eve in 2019 and 2020. Data were analyzed with the Chi-square statistical test. Results: Over the study periods, there were 31,855 and 25,244 patients presented to the ED in 2019 and 2020 respectively. During the epidemic period in 2020, the daily number of average ED visits was lower than that in 2019 (430±134.9 v.s. 572±38.6, p=0.00), with fewer triage 1&2 cases (145±33.3 v.s.178±15.0, p=0.00). Nevertheless, the mortality increased slightly during the epidemic period in 2020 (0.2% vs. 0.1%, p=0.009), with higher Apache II scores (28 vs.19, p= 0.022) and shorter ED elapsed time ( 0.2 vs. 1.4 days, p=0.016) among these death cases. Conclusions: The COVID-19 epidemic had an evident impact on the patient’s behavioral patterns and routine emergency services, which caused higher ED mortality. Hospitals should make an effort to balance the supply and demand for medical resources. Funding Statement: Scientific and technological project of new coronavirus pneumonia, 2019 (HX-2019- nCoV-026), Sichuan University West China Hospital. Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: This study received ethical approval from West China Hospital Human Research Ethics Committee.