The Impact of the Coronavirus Disease 2019 Outbreak on the Attendance of Patients with Surgical Complaints at a Tertiary Hospital Emergency Department

Introduction: Emergency departments (EDs) during the novel coronavirus disease 2019 (COVID-19) pandemic are perceived as possible sources of infection. The effects of COVID-19 on patients presenting to the hospital with surgical complaints remain uncertain. Methods: A single tertiary center retrospective study analysis compared the ED attendance rate and severity of patients with surgical complaints between March 2020 (COVID-19 outbreak) and pre-COVID-19 periods: February 2020 and the same 2 months in 2019 and 2018. Results: Overall, 6,017 patients were included. The mean daily ED visits of patients with nontrauma surgical complaints in the COVID-19 outbreak period declined by 27%-32% (P value <.01) compared with pre-COVID-19 periods. The log number of confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Israel in March 2020 was negatively correlated with the number of ED visits (Pearson's r =-0.59, P <.01). The proportion of patients requiring hospitalization increased by up to 8% during the outbreak period (P <.01), and there was a higher proportion of tachycardic patients (20% versus 15.5%, P =.01). The percentage of visits to the ED by men declined by 5% (P <.01). The ED diagnosis distribution significantly changed during COVID-19 (P =.013), with an 84% decrease in the number of patients hospitalized for diverticular disease (P <.05). Conclusion: During the COVID-19 outbreak, the overall number of patients presenting at the ED with surgical complaints decreased significantly, and there was a higher admissions ratio. The extent to which the pandemic affects hospital ED attendance can help health care professionals prepare for future such events.