Hospital Volumes of 5 Medical Emergencies in the COVID-19 Pandemic in 2 US Medical Centers

Study identified significant drops in the daily caseload of 4 common medical emergencies (acute MI, ischaemic stroke, nontraumatic subarachnoid haemorrhage, ectopic pregnancy, appendicitis) following the onset of the COVID-19 pandemic.

SPS commentary:

The researchers note the combination of fewer patients presenting with medical emergencies and an increased number of non–COVID-19–related at-home deaths is concerning. They suggest fear of exposure to patients with COVID-19 may lead individuals to defer care for acute conditions

This is one of two articles in JAMA Internal Medicine that shed light on another cost of the COVID-19 pandemic; deferral of care for serious non–COVID-19 conditions, such as myocardial infarction and stroke. A retrospective study of admissions to 4 hospitals in New York found hospitalisation rates decreased during peak COVID-19 period suggesting either sick patients aren’t obtaining necessary hospital care or prior overuse of hospitalisation or improved self-management.

An editorial suggests it is possible that certain types of care can be forgone without harm; and it could be that in some cases, patients may have been receiving unnecessary care. It discusses what could drive patients to defer essential care and what can be done about it.

JAMA Internal Medicine

Resource links:

Editorial

Study (New York)