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Background There is increasing evidence that patients avoid emergency departments due to fear of contracting COVID-19, which increases morbidity and mortality. To ensure the effectiveness of emergency services, department's performance must be measured. Today, various tools and methods are used to measure the performance indicators of the emergency department. Methods The current study is a descriptive-analytical cross-sectional study, which was conducted in the year 1400 in the emergency department of Kowsar hospital in Sanandaj. The research population included all patients admitted through triage from 1397 to 1400. Data were collected using SPSS statistical software version 23 and descriptive statistics (percentage, frequency, mean and standard deviation) and inferential (ANOVA, independent t-test, and post hoc test) were subjected to statistical analysis. A P value of 0.05 was considered. Results In the data related to emergency admissions after Corona during the outbreak of the disease, the first, second, third, fourth and fifth periods of the epidemic compared to the same period in the previous year were 48.7, 34.1, 31.7, 25.2, and 16.2, respectively. Percentage decreased. The average age of clients increased from 33.50 to 36.93 during the epidemic. In the study of the gender variable, before covid-19, 56.5% of clients were men, and 43.5% were women. After the pandemic, these percentages reached 62.5% and 37.5%, respectively. The index of assignment within 6 hours averaged 84.69% in 4 years, which has increased after the Covid-19 pandemic. The percentage of patients discharged under 12 hours was also calculated with an average of 94.54% in 4 years, which has decreased after the covid-19 pandemic. The percentage of self-responsible discharges in the emergency department was 40.8% before and 59.2% after the Covid-19 pandemic, which has been increasing. The index of unsuccessful cardiopulmonary resuscitation decreased from 112 cases before the pandemic to 64 cases after. The average duration of triage during four years was calculated as 8.11 minutes, which increased significantly compared to before. Conclusion The Covid-19 pandemic has had greatly impacted patient referrals to the emergency department. This research showed that the beginning of the covid-19 pandemic affected emergency management indicators and patients' visits to the emergency room.