MMWR Morb Mortal Wkly Rep. 2021 Apr 16;70(15):552-556. doi: 10.15585/mmwr.mm7015a3.
During March 29-April 25, 2020, emergency department (ED) visits in the United States declined by 42% after the declaration of a national emergency for COVID-19 on March 13, 2020. Among children aged ≤10 years, ED visits declined by 72% compared with prepandemic levels (1). To assess the continued impact of the COVID-19 pandemic on EDs, CDC examined trends in visits since December 30, 2018, and compared the numbers and types of ED visits by patient demographic and geographic factors during a COVID-19 pandemic period (December 20, 2020-January 16, 2021) with a prepandemic period 1 year earlier (December 15, 2019-January 11, 2020). After an initial decline during March-April 2020 (1), ED visits increased through July 2020, but at levels below those during the previous year, until December 2020-January 2021 when visits again fell to 25% of prepandemic levels. During this time, among patients aged 0-4, 5-11, 12-17, and ≥18 years, ED visits were lower by 66%, 63%, 38%, and 17%, respectively, compared with ED visits for each age group during the same period before the pandemic. Differences were also observed by region and reasons for ED visits during December 2020-January 2021; more visits during this period were for infectious diseases or mental and behavioral health-related concerns and fewer visits were for gastrointestinal and upper-respiratory-related illnesses compared with ED visits during December 2019-January 2020. Although the numbers of ED visits associated with socioeconomic factors and mental or behavioral health conditions are low, the increased visits by both adults and children for these concerns suggest that health care providers should maintain heightened vigilance in screening for factors that might warrant further treatment, guidance, or intervention during the COVID-19 pandemic.
2020 年 3 月 13 日美国宣布因 COVID-19 进入全国紧急状态后,2020 年 3 月 29 日至 4 月 25 日期间,急诊就诊量下降了 42%。在年龄≤10 岁的儿童中,急诊就诊量较大流行前水平下降了 72%(1)。为评估 COVID-19 大流行对急诊就诊的持续影响,CDC 分析了 2018 年 12 月 30 日以来的就诊趋势,并将大流行期间(2020 年 12 月 20 日至 2021 年 1 月 16 日)和大流行前一年同期(2019 年 12 月 15 日至 2020 年 1 月 11 日)的就诊数量和类型与患者人口统计学和地理因素进行了比较。2020 年 3 月至 4 月就诊量下降后(1),就诊量在 7 月前持续增加,但仍低于前一年同期水平,直到 2020 年 12 月至 2021 年 1 月,就诊量再次下降至大流行前水平的 25%。在此期间,0-4 岁、5-11 岁、12-17 岁和≥18 岁患者的就诊量分别较大流行前同期各年龄段下降 66%、63%、38%和 17%。此外,不同地区和就诊原因也存在差异;与 2019 年 12 月至 2020 年 1 月相比,2020 年 12 月至 2021 年 1 月期间,更多的就诊是由于传染病或精神和行为健康相关问题,而与胃肠道和上呼吸道相关的疾病就诊量则减少。尽管与社会经济因素和精神或行为健康状况相关的就诊数量较少,但成年人和儿童对这些问题的就诊量增加表明,在 COVID-19 大流行期间,医疗服务提供者应保持高度警惕,筛查可能需要进一步治疗、指导或干预的因素。