Comparison of Emergency Department Patient Visits One Year Before and After the Start of the COVID-19 Pandemic

Objective: Planning for emergency department (ED) services based on epidemiological data is essential. This study retrospectively examined ED patient presentations at a tertiary hospital 1 year before and 1 year after the start of the coronavirus 2019 (COVID-2019) pandemic to assist with planning efforts.
Materials and Methods: The study period was March 1, 2019 to February 28, 2021. The patient cases were separated into 2 groups using a reference date of March 2020. The period between March 1, 2019 and February 29, 2020 was de-fined as the pre-COVID period, or ordinary circumstances, and the period between March 1, 2020 and February 28, 2021 was defined as the period following the COVID-19 outbreak, which reflected extraordinary conditions. The primary outcome was the difference in the number of patients and the mortality rate between groups.
Results: A total of 74,063 (62%) people presented at the ED in the pre-COVID period, and there were 45,397 (38%) ED visits in the post-COVID period. The median daily number of patients seen in the pre-COVID period was significantly higher than that of the post-COVID period (200.5 [181–219.25] vs. 123 [108.5–139], respectively [p<0.001]). The in-hospital mortality rate and the hospitalization rate in the post-COVID period were significantly higher than in the pre-COVID period (in-hospital mortality rate: 1105 [2.4%], 852 [1.2%], [p<0.001]; hospitalization rate: 9404 [20.7%], 9019 [12.2%], [p<0.001]).
Conclusion: Although the number of patients presenting at the ED decreased in the period after the outbreak of COVID-19, the number of those who died increased. While the number of hospitalized patients was similar between the 2 groups, the hospitalization rate was greater in the post-COVID period. This information and additional detailed study may prove useful to ED planning efforts.