Adult emergency department visits during the COVID-19 pandemic in Veneto region, Italy: a time-trend Analysis

Background: Literature comparing variations in ED presentations pre- and post- COVID-19 pandemic is currently scarce and limited to the first pandemic wave. This study aimed to analyze ED presentation rates and features through two pandemic waves in Northeastern Italy. Methods: Data were derived from the ED visits dataset of Veneto (Northeastern Italy). ED presentations in 2019 and 2020 of all patients ≥15 years were collected. All records included access mode, triage code, clinical presentation, and outcome. A year-on-year variation and descriptive trends were reported. Results : Overall, 2,868,767 ED presentations were included (1,665,895 in 2019; 1,202,872 in 2020). A 28% decrease was observed throughout 2020, with a peak during the first pandemic wave (March-April 2020: -52%) and a less pronounced reduction during the second wave (November-December 2020: -37%). “Burn or trauma” was the most common presentation over the entire study period, despite a marked reduction during the lockdown, while dyspnea was the second most common complaint during both pandemic waves. Green and white triage codes showed the greatest reduction in 2020 (-32% and -30%, respectively). Hospitalizations following the ED increased from 15% in 2019 to 21% in 2020. Conclusions: The marked reduction in ED visits observed in 2020, especially in March-April, is likely to be attributed to direct and indirect consequences of lockdown. The fear of contagion probably led the population to avoid medical attention especially for non-urgent conditions. Future public health policies must ensure the correct use of emergency medical care by the population, both in ordinary times and during pandemics.