COVID-19: Impacts on the Ophthalmology Urgency
DOI:
https://doi.org/10.48560/rspo.23851Keywords:
Coronavirus Infections, COVID-19 , Emergency Service, Hospital; Eye Diseases, Facilities and Services Utilization, Ophthalmology, PandemicsAbstract
Introduction: The COVID-19 pandemic settled in Portugal in March 2020 and its consequences are still poorly understood. This study intends to evaluate the impact of it on the type of diagnoses and severity of the situations that appeared in the Emergency Department (ED) of Ophthalmology at the CHUC (Centro Hospitalar e Universitário de Coimbra) in the first months of the pandemic. Possible reasons for the changes observed are being discussed and the aim is to improve the organization of the teams and their differentiation, should new restrictions on the functioning of society and medical care arise.
Methods: Retrospective observational study on the casuistry of the CHUC Ophthalmology SU on March 1 to June 30 of 2019 and 2020. The chi-square test was applied to compare the number of monthly visits to the SU by diagnosis of admission after normality analysis with the Shapiro-Wilk test and the T test for independent samples compared the number of admissions in the two years. The data were provided by the CHUC Information Technology and Systems Service.
Results and Discussion: The total number of visits to the CHUC Ophthalmology SU decreased from 5 709 to 3 490 (-38.9%) in the months under study (p <0.05). Conditions such as blepharoconjunctivitis (-69.7%) and acute conjunctivitis (-66.5%) were those that suffered the greatest decrease. The pathology that suffered proportionally less change was a foreign body in the cornea (+ 2.7%). On the other hand, diagnoses such as vitreous hemorrhage (+ 61.6%) and unspecified retinal detachment (+ 37.5%) increased in absolute frequency, although the impact of the pandemic on them is not proven (p> 0.05). The containment measures implemented, the fear of COVID-19 infection in the hospital and a decrease in occupational accidents are some of the causes mentioned.
Conclusion: There is a clear association between the beginning of the pandemic in our country and the reduction of visits to the ED, which led to the decrease in less urgent cases and the increase in more serious diagnoses such as retinal detachment and foreign body in the cornea. The response to non-urgent cases must be improve so as not to overburden the ED with conditions that do not require immediate or face-to-face treatment.
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References
Portugal. Ministério da Saúde. DGS. Perguntas Frequentes Categoria: COVID-19 [Internet]. 2020 [cited 2020 Aug 13]. Available from: https://covid19.min-saude.pt/category/perguntas-frequentes/
Portugal. Ministério da Saúde. DGS. Relatório de situação epidemiológica em Portugal [Internet]. Lisboa; 2020 [cited 2020 Aug 13]. p. 4. Available from: https://covid19.min-saude.pt/
Presidente da República. Decreto do Presidente da República 14-A/2020, 2020-03-18 - DRE. Diário da República no 55/2020, 3o Supl Série I [Internet]. 2020;(2):13-(2)-13-(4). Available from: https://dre.pt/web/guest/home/-/dre/130399862/details/maximized
Portugal. Presidência do Conselho de Ministros. Resolução do Conselho de Ministros n.o 33-A/2020: Declara a situação de calamidade, no âmbito da pandemia da doença COVID-19. Diário da República n.o 85/2020, 3o Suplemento, Série I de 2020-04-30 2020 p. 7-(10) a 7-(21).
Portugal. Ministério da Saúde. DGS. Relatório de situação epidemiológica em Portugal [Internet]. 2020 [cited 2020 Nov 26]. Available from: https://covid19.min-saude.pt/wp-content/uploads/2020/11/269_DGS_boletim_20201126-002.pdf
Presidente da República. Decreto do Presidente da República n.o 51-U/2020 de 6 de novembro [Internet]. 2020 p. 12-(2),12-(3). Available from: www.dre.pt
Lee SY, Khang YH, Lim HK. Impact of the 2015 middle east respiratory syndrome outbreak on emergency care utilization and mortality in South Korea. Yonsei Med J. 2019;60(8):796–803.
Huang C, Lee C, Huang H, Yen DH, Kao W WL. Declining Emergency Department Visits and Costs During the Severe Acute Respiratory Syndrome (SARS) Outbreak. 2006. p. 31–7.
Portugal. Ministério da Saúde. ACSS. Recomendações Técnicas para Serviços de Urgências. 2015.
Portugal. Universidade Nova de Lisboa. Escola Nacional de Saúde Pública. Barómetro Covid-19 | ENSP-NOVA — Utilização dos Serviços de Saúde em tempos de Covid-19 [Internet]. 2020 [cited 2020 Aug 13]. Available from: https://barometro-covid-19.ensp.unl.pt/utilizacao-dos-servicos-de-saude-em-tempos-de-covid-19/
Portugal. Ministério da Saúde. CHUC E. O CHUC em números [Internet]. [cited 2020 Aug 13]. Available from: https://www.chuc.min-saude.pt/paginas/o-chuc-em-numeros.php
Portugal. Ministério da Saúde. SNS. Serviços de Urgência [Internet]. [cited 2020 Nov 12]. Available from: https://www.sns.gov.pt/monitorizacao-do-sns/servicos-de-urgencia/
Babu N, Kohli P, Mishra C, Sen S, Arthur D, Chhablani D, et al. To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Indian J Ophthalmol. 2020 Aug 1;68(8):1540–4.
Pellegrini M, Roda M, Di Geronimo N, Lupardi E, Giannaccare G, Schiavi C. Changing trends of ocular trauma in the time of COVID-19 pandemic. Eye. 2020;34(7):1248–50.
Wickham L, Hay G, Hamilton R, Wooding J, Tossounis H, da Cruz L, et al. The impact of COVID policies on acute ophthalmology services—experiences from Moorfields Eye Hospital NHS Foundation Trust. Eye. 2020;34(7):1189–92.
Boserup B, McKenney M, Elkbuli A. The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States. Am J Emerg Med. 2020 Sep 1;38(9):1732–6.
Fitzpatrick KM, Harris C, Drawve G. Fear of COVID-19 and the Mental Health Consequences in America. Psychol Trauma Theory, Res Pract Policy. 2020;12(S1):S17–21.
Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Heal. 2020;17:1729.
Gerhold L. COVID-19 : Risk perception and Coping strategies. Results from a survey in Germany. Interdiscip Secur Res Gr. 2020;1–11.
Mantica G, Riccardi N, Terrone C, Gratarola A. Non-COVID-19 visits to emergency departments during the pandemic: the impact of fear. Vol. 183, Public Health. Elsevier B.V.; 2020. p. 40–1.
González Armengol J, Vázquez-Lima T. Los Servicios de Urgencias y Emergencias ante la pandemia por SARS-CoV-2 TT - Emergency services and the fight against the SARS-CoV-2 pandemic. Emergencias (Sant Vicenç dels Horts). 2020;32(3):155–6.
Portugal. Governo da República Portuguesa. Comunicado do Conselho de Ministros de 19 de março de 2020 [Internet]. 2020 [cited 2020 Sep 5]. Available from: https://www.portugal.gov.pt/pt/gc22/governo/comunicado-de-conselho-de-ministros?i=334
Portugal. Ministério da Saúde. DGS. Relatório de Situação - COVID-19 [Internet]. 2020 [cited 2020 Nov 12]. Available from: https://covid19.min-saude.pt/relatorio-de-situacao/
Portugal. Governo da República Portuguesa. Comunicado do Conselho de Ministros de 30 de abril de 2020 [Internet]. 2020 [cited 2020 Nov 12]. Available from: https://www.portugal.gov.pt/pt/gc22/governo/comunicado-de-conselho-de-ministros?i=344
Pellegrini M, Roda M, Lupardi E, Geronimo N Di, Giannaccare G, Schiavi C. The impact of COVID-19 pandemic on ophthalmo-logical emergency department visits. Acta Ophthalmol. 2020.
Anteby R, Zager Y, Barash Y, Nadler R, Cordoba M, Klang E, et al. The Impact of the Coronavirus Disease 2019 Outbreak on the Attendance of Patients with Surgical Complaints at a Tertiary Hospital Emergency Department. J Laparoendosc Adv Surg Tech. 2020;00(00):1–7.
Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits — United States, January 1, 2019–May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699–704.
Nuñez JH, Sallent A, Lakhani K, Guerra-Farfan E, Vidal N, Ekhtiari S, et al. Impact of the COVID-19 Pandemic on an Emergency Traumatology Service: Experience at a Tertiary Trauma Centre in Spain. Injury. 2020;51:1414–8.
Santana R, Sousa JS, Soares P, Lopes S, Boto P, Rocha JV. The Demand for Hospital Emergency Services: Trends during the First Month of COVID-19 Response. Port J Public Heal. 2020;38(1):30–6.
Rohl A, Kalhorn A, Singh J, Mandava N. Decreased retinal detachments during a COVID-19 lockdown period in Colorado. Acta Ophthalmol. 2020.
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