Stirparo Giuseppe, Pireddu Roberta, Andreassi Aida, Sechi Giuseppe Maria, Signorelli Carlo
School of Public Health, Faculty of Medicine, University of Vita-Salute San Raffaele, Milan20132, Italy.
Department of Research and Development, Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milan20124, Italy.
Prehosp Disaster Med. 2023 Apr;38(2):243-246. doi: 10.1017/S1049023X23000286. Epub 2023 Mar 13.
Coronavirus disease 2019 (COVID-19) has dramatically changed the epidemiology of several diseases. Much evidence on this has been published in the pandemic phase. In addition, many studies have shown that phenomena such as stress, substance abuse, and burnout increased in the general population during the lockdown. Unfortunately, few studies analyze the post-pandemic phase.
The study aimed to evaluate the trend of broad social problems, such as a diagnosis by the emergency department (ED), in the post-pandemic phase in the Lombardy (Italy) region.
The study is a retrospective observational cohort study. All admissions to emergency rooms in the Lombardy region registered in the Emergency Urgency OnLine (EUOL) portal made from January through June 2019 were analyzed, having as main causes: psychiatric disorders, self-harm, substance abuse, social disadvantage, and violence. All accesses in emergency rooms in the Lombardy region registered in the EUOL portal made from January 1, 2019 through June 30, 2019 were analyzed and compared with the same period in 2022.
The study recorded an increase in the likelihood of events of self-harm (OR = 2.1; 95% CI, 1.8-2.6; P <.0001), substance abuse (OR = 1.2; 95% CI, 1.1-1.3; P <.0001), violence by others (OR = 1.3; 95% CI, 1.2-1.4; P <.0001), and social disadvantage (OR = 1.2; 95% CI, 1.1-1.4; P = .0045). The events are more concentrated in suburban areas (OR = 1.3; 95% CI, 1.2-1.4; P <.001).
The increase in diagnoses of these social problems in the ED is only the culmination of a phenomenon that hides an underlying rise in social illness. In the post-COVID-19 phase, there is a need to invest in community care and social illness prevention policies.
2019年冠状病毒病（COVID-19）极大地改变了多种疾病的流行病学特征。在疫情期间已发表了许多关于此的证据。此外，许多研究表明，在封锁期间，普通人群中的压力、药物滥用和职业倦怠等现象有所增加。遗憾的是，很少有研究分析疫情后阶段的情况。
本研究旨在评估意大利伦巴第地区疫情后阶段广泛的社会问题趋势，如急诊科诊断情况。
本研究为回顾性观察队列研究。对2019年1月至6月在紧急在线（EUOL）门户网站上登记的伦巴第地区所有急诊室就诊病例进行分析，主要病因包括：精神障碍、自残、药物滥用、社会劣势和暴力行为。对2019年1月1日至2019年6月30日在EUOL门户网站上登记的伦巴第地区所有急诊室就诊病例进行分析，并与2022年同期进行比较。
该研究记录了自残事件（OR = 2.1；95% CI，1.8 - 2.6；P <.0001）、药物滥用（OR = 1.2；95% CI，1.1 - 1.3；P <.0001）、他人暴力行为（OR = 1.3；95% CI，1.2 - 1.4；P <.0001）和社会劣势（OR = 1.2；95% CI，1.1 - 1.4；P =.0045）发生可能性的增加。这些事件在郊区更为集中（OR = 1.3；95% CI，1.2 - 1.4；P <.001）。
急诊科对这些社会问题诊断的增加只是隐藏着社会疾病潜在上升现象的一个 culmination（此处原文有误，可理解为“结果”）。在COVID - 19后阶段，需要投资于社区护理和社会疾病预防政策。
