Comelli Ivan, Scioscioli Francesco, Cervellin Gianfranco
University Hospital of Parma.
University Hospital of Parma, Italy.
Acta Biomed. 2020 May 11;91(2):45-49. doi: 10.23750/abm.v91i2.9565.
The spread of coronavirus disease 2019 (COVID-19) is overwhelming the response of many regional health services across Italy. This article aims to report and discuss the data of the first 8 weeks of COVID-19 epidemic in the emergency department (ED) of the University Hospital of Parma.
The ED visits were analyzed as follows: total ED visits, divided in COVID-19/ non-COVID-19 cases, and in trauma-related/non-trauma-related cases; outcome (i.e., discharged, admitted, dead in the ED) of patients, altogether or stratified according to triage class; age classes of the entire ED population.
Total ED visits decreased starting from the first days of the outbreak, then exhibiting progressive growth afterwards. COVID suspected cases rapidly increased, whereas non-COVID suspected dropped and remained well below the standard. Trauma-related cases declined, both as ED visits and as hospital admissions. The percentage and absolute number of patients admitted to hospital wards progressively increased, rapidly overwhelming the number of cases that could be discharged. The admission rate in the lowest priority classes also displayed a marked increase. The youngest age classes dramatically declined, whilst the oldest progressively increased, remaining considerably over the standard rate of the local ED.
The COVID-19 pandemic has obliged the health care systems to undergo a paradigm shift. Even triage criteria have partially lost their meaning, as shown by the dramatic increase of hospital admissions, even in the lowest priority classes. A deep re-organizational process of the ED was undertaken. Hospitals must be constantly resilient and prepared to these new emergencies in terms of equipment, medical and nurses staff, larger bed capacity in short time, availability of intensive and sub-intensive beds, and flexibility.
2019年冠状病毒病（COVID-19）的传播使意大利许多地区卫生服务部门的应对工作不堪重负。本文旨在报告和讨论帕尔马大学医院急诊科COVID-19疫情前8周的数据。
对急诊科就诊情况进行如下分析：急诊就诊总数，分为COVID-19/非COVID-19病例，以及创伤相关/非创伤相关病例；患者的结局（即出院、入院、在急诊科死亡），整体或按分诊类别分层；整个急诊科人群的年龄组。
从疫情爆发的第一天起，急诊就诊总数开始下降，随后呈逐步增长趋势。疑似COVID病例迅速增加，而非COVID疑似病例下降并远低于标准水平。与创伤相关的病例无论是急诊就诊还是住院人数都有所下降。入院病房的患者百分比和绝对数量逐渐增加，迅速超过了可以出院的病例数量。最低优先级别的入院率也显著增加。最年轻的年龄组急剧下降，而最年长的年龄组逐渐增加，仍大大高于当地急诊科的标准率。
COVID-19大流行迫使医疗保健系统经历了范式转变。即使是分诊标准也部分失去了意义，住院人数的急剧增加就表明了这一点，即使是在最低优先级别的类别中。急诊科进行了深刻的重组过程。医院必须在设备、医护人员、短期内更大的床位容量、重症和亚重症床位的可用性以及灵活性方面始终保持弹性并为这些新的紧急情况做好准备。
