Departments of Emergency and Acute Medicine, Campus Mitte and Virchow-Klinikum Charité-Universitätsmedizin Berlin
Department of Emergency Medicine, University Hospital Jena
Dtsch Arztebl Int. 2020 Aug 17;117(33-34):545-552. doi: 10.3238/arztebl.2020.0545.
In this study, we investigate the number of emergency room consultations during the COVID-19 pandemic of 2020 in Germany compared to figures from the previous year.
Case numbers from calendar weeks 1 through 22 of the two consecutive years 2019 and 2020 were obtained from 29 university hospitals and 7 non-university hospitals in Germany. Information was also obtained on the patients' age, sex, and urgency, along with the type of case (outpatient/inpatient), admitting ward, and a small number of tracer diagnoses (I21, myocardial infarction; J44, COPD; and I61, I63, I64, G45, stroke /TIA), as well as on the number of COVID-19 cases and of tests performed for SARS-CoV-2, as a measure of the number of cases in which COVID-19 was suspected or at least included in the differential diagnoses.
A total of 1 022 007 emergency room consultations were analyzed, of which 546 940 took place in 2019 and 475 067 in 2020. The number of consultations with a positive test for the COVID-19 pathogen was 3122. The total number of emergency room consultations in the observation period was 13% lower in 2020 than in 2019, with a maximum drop by 38% coinciding with the highest number of COVID-19 cases (calendar week 14; 572 cases). After the initiation of interpersonal contact restrictions in 2020, there was a marked drop in COVID-19 case numbers, by a mean of -240 cases per week per emergency room (95% confidence interval [-284; -128]). There was a rise in case numbers thereafter, by a mean of 17 patients per week [14; 19], and the number of cases of myocardial infarction returned fully to the level seen in 2019.
In Germany, the COVID-19 pandemic led to a significant drop in medical emergencies of all kinds presenting to the nation's emergency departments. A recovery effect began to be seen as early as calendar week 15, but the levels seen in 2019 were not yet reached overall by calendar week 22; only the prevalence of myocardial infarction had renormalized by then. The reasons for this require further investigation.
在这项研究中，我们调查了 2020 年德国 COVID-19 大流行期间与前一年相比急诊就诊的次数。
我们从德国 29 所大学医院和 7 所非大学医院获得了 2019 年和 2020 年连续两年的第 1 周到第 22 周的病例数。还获得了患者的年龄、性别、紧急程度、以及病例类型（门诊/住院）、收治病房以及少数示踪诊断（I21、心肌梗死；J44、COPD；以及 I61、I63、I64、G45、中风/TIA），以及 COVID-19 病例数和 SARS-CoV-2 的检测数，作为 COVID-19 疑似病例或至少包含在鉴别诊断中的病例数的衡量标准。
共分析了 1022007 例急诊就诊，其中 546940 例发生在 2019 年，475067 例发生在 2020 年。COVID-19 病原体检测呈阳性的就诊次数为 3122 次。与 2019 年相比，2020 年观察期内的急诊就诊总数减少了 13%，最大降幅为 38%，恰逢 COVID-19 病例数最高（第 14 周；572 例）。2020 年人际接触限制开始后，COVID-19 病例数明显下降，每个急诊室每周平均减少 240 例（95%置信区间[-284；-128]）。此后，病例数有所增加，每周增加 17 例[14；19]，心肌梗死的病例数也完全恢复到 2019 年的水平。
在德国，COVID-19 大流行导致全国急诊部门接诊的各种医疗急症显著减少。早在第 15 周就开始出现恢复效应，但到第 22 周仍未达到 2019 年的总体水平；到那时，只有心肌梗死的发病率才恢复正常。这方面的原因需要进一步调查。
