Changes in the use of Otorhinolaryngology Emergency Department during the COVID-19 pandemic: report from Lombardy, Italy

Elli, Fabrizia; Turri‐Zanoni, Mario; Arosio, Alberto Daniele; Karligkiotis, Apostolos; Battaglia, Paolo; Castelnuovo, Paolo

doi:10.1007/s00405-020-06119-z

Cited by 17 publications

(16 citation statements)

References 5 publications

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“…The postponement is in-line with measures adopted by comparable departments in Italy, a country which adopted a similar severe lockdown as South Africa. (6) The 21% decrease in the number of surgical procedures performed in theatre during the post-lockdown period in our study was not significant. A study by Ralli et al in Italy documented a 50.8% decrease in the number of ENT procedures.…”

Section: Discussioncontrasting

confidence: 56%

The Impact of the Lockdown on ENT Services during the COVID-19 Pandemic in Johannesburg

Maharaj¹,

Hari²

2020

Wits Journal of Clinical Medicine

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Background: The novel coronavirus and accompanying lockdown measures have resulted in the disruption of specialist clinic services. There have been reports of a decrease in the number of clinic attendees and surgical procedures performed in clinics throughout the world. Methods: The study period was from 2 January 2020 until 19 June 2020 which was divided by the lockdown date of 26 March 2020, into two periods of 85 days for comparative review. Results: During the pre-lockdown phase (2 January 2020 to 25 March 2020), 2160 patients were booked for the outpatient clinics and 1911 attended in this period (88.5%). In contrast, during the post-lockdown period (26 March 2020 to 19 June 2020), 1220 visits were scheduled. Of these, 937 (76.8%) visits were completed. The number of patient visits booked (P = 0.01) and completed (P = 0.0001) after lockdown declined significantly. During the pre-lockdown phase, 228 theatre cases were completed, including 66 emergencies, and during the post-lockdown phase, there were 188 cases together with 48 emergencies. There were no elective cases post-lockdown. Conclusion: The study illustrates that even during a stringent lockdown period, there is an ongoing need for specialist ENT services. Health-care systems need to be tailored to manage all patients such that care is not shifted away from vulnerable groups and solely focused on COVID-19 patients.

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Section: Discussioncontrasting

confidence: 56%

The Impact of the Lockdown on ENT Services during the COVID-19 Pandemic in Johannesburg

Maharaj¹,

Hari²

2020

Wits Journal of Clinical Medicine

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“…Bellan and colleagues reported a reduction of 46.3% of adult ED visits during COVID-19 from March 1st to April 13th in Novara (Northern Italy) [21]. Ophthalmological (− 73% vs. 2019) and otorhinolaryngoiatric (− 91% vs. 2018) ED visits also decreased during Italian COVID-19 pandemic [22,23]. Interestingly, from March 10th to April 20th, 2020, the proportion of children and adolescents presenting to ophthalmological ED halved from 10 to 5.3% in comparison with 2019 [22].…”

Section: Discussionmentioning

confidence: 99%

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

Vierucci¹,

Bacci

Mucaria

et al. 2020

SN Compr. Clin. Med.

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Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11-22); lockdown, 3 (1-3); phase 2, 3 (3-5), p < 0.0001). On the other hand, the percentage of children discharged right after pediatric visit significantly decreased from 80% in January to 50% in April. After March 9th, we registered a change in the diagnoses of emergency department visits, with an increase in the percentage of non-infectious acute conditions and a decrease in infectious diseases, with two cases of a noteworthy delayed access to hospital care. We performed a retrospective analysis of consultations requested to our pediatric unit for children and adolescents referred to the general Emergency Department of San Luca Hospital of Lucca (Tuscany, Central Italy) from January 1st to May 31st, 2020. We split data in two different time periods according to consultations performed before (January 1st-March 8th) and after the beginning of lockdown (March 9th-May 31st). Analyzing the number of children hospitalized from January to May 2020 in comparison with the same period in 2019, a decreased hospitalization became evident after March (March − 74.6%, April − 71.6%, May − 58.6%). Nasopharyngeal What is Known: Italy was the first European country hit by SARS-CoV-2 infection. Published preliminary Italian data confirmed a general favorable clinical course of COVID-19 in childhood. What is New: Even if COVID-19 pandemic more seriously affected Northern Italy, the admission of children and adolescents to pediatric emergency services significantly changed also in Central Italy with reduced demand and increased appropriateness.

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“…The postponement is in line with measures adopted by comparable departments in Italy, a country which adopted a similar severe lockdown. 31,32 The decrease in the number of surgical procedures performed during the post-lockdown period was deemed insignificant (p = 0.67). Ralli et al in their study documented a 50.8% decrease in the number of ENT procedures done and this drastic reduction was explained by the timing of their study, which included the period during which Italy experienced their highest proportion of COVID-19 infections.…”

Section: Ent Services During the Covid-19 Pandemic: A South African Ementioning

confidence: 94%

“…It was noted during the analysis of the data that the monthly patient attendance at the outpatient clinics was fairly consistent in the pre-lockdown phase up to 25 March 2020 (31)(32)(33)(34)(35), in terms of patients seen per day. During the immediate period after lockdown, which included 4 clinic days in March and the following month of April, the patient attendance reduced drastically (10 per day).…”

Section: Ent Services During the Covid-19 Pandemic: A South African Ementioning

confidence: 94%

COVID-19 and otorhinolaryngology: Returning to practice

Maharaj

2021

Southern African Journal of Infectious Diseases

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This article aims to focus on key points and provide an overview of the current knowledge of the Coronavirus Disease (COVID-19); the increased susceptibility of otorhinolaryngologists to the virus; its effects and impact on the ENT practice; disruption of specialist clinic services; as well as associated risks in ENT surgical procedures. Mitigation strategies that can be employed to efficiently return to practice and ensuring the highest level of safety to both the patient and the otorhinolaryngologist is emphasised whilst simultaneously adapting to the new normal. Attention was given to understanding of the virus, its effect on the ENT discipline and practice, counter measures to mitigate and minimise risk to allow for continuation of ENT services once restrictions and lockdowns are progressively lifted. Otorhinolaryngological manifestations are common symptoms of COVID-19. Evidence suggests that the highest rates of nosocomial spread were seen amongst otorhinolaryngologists. The COVID-19 pandemic unexpectedly halted a majority of the otorhinolaryngology activities, which impacted service provision in the ENT practice. As the pandemic evolves, and with its duration unpredictable, this may necessitate a fundamental shift in the way otorhinolaryngology is practiced as there may be further global viral pandemics in future and the ENT fraternity has to now adapt to the new normal. Continued vigilance is imperative and strategies optimally implemented to ensure safe return to both ENT specialist clinic services and surgeries is vital. There are currently no uniform best-practice recommendations for otorhinolaryngology in the COVID-19 setting, although key strategies to prevent the virus spread have become evident to be able to effectively ‘flatten the curve’ of COVID-19 infections over time.

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Changes in the use of Otorhinolaryngology Emergency Department during the COVID-19 pandemic: report from Lombardy, Italy

Cited by 17 publications

References 5 publications

The Impact of the Lockdown on ENT Services during the COVID-19 Pandemic in Johannesburg

The Impact of the Lockdown on ENT Services during the COVID-19 Pandemic in Johannesburg

How COVID-19 Pandemic Changed Children and Adolescents Use of the Emergency Department: the Experience of a Secondary Care Pediatric Unit in Central Italy

COVID-19 and otorhinolaryngology: Returning to practice

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