Ophthalmological emergencies and the SARS-CoV-2 outbreak

Abstract

Since the end of 2019, an outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), originating in the Chinese city of Wuhan has spread rapidly worldwide causing thousands of deaths. Coronavirus disease (COVID-19) is supported by SARS-CoV-2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Italy has been the first European country recording an elevated number of infected forcing the Italian Government to call for total lockdown. The lockdown had the aim to limit the spread of infection through social distancing. The purpose of this study is to analyze how the pandemic has affected the patient's accesses to the Ophthalmological Emergency Department of a tertiary referral center in central-northern Italy, during the lockdown period. The charts of all patients that came to the Emergency Department during the lockdown period (March 10-May 4, 2020) have been retrospectively collected and compared with those in the same period of 2019 and the period from 15 January-9 March 2020. A significant reduction of visits during the lockdown has been observed, compared with those of pre-lockdown period (reduction of 65.4%) and with those of the same period of 2019 (reduction of 74.3%). Particularly, during the lockdown, minor and not urgency visits decreased whereas the undeferrable urgency ones increased. These pieces of evidence could be explained by the fear of patients to be infected; but also revealed patients misuse of emergency services.

Retrospective analysis of ophthalmology referrals during the COVID-19 pandemic compared to prepandemic

“…to 14.1 percentage points. 8,9 These findings were in line with those found by the current study, as would be expected from studies carried out in similar public healthcare institutions in the midst of the pandemic.…”

“…These studies found a 65% to 73% decrease in the number of ophthalmic emergencies in 2020 in comparison to a comparable period. [8][9][10] Comparatively emergent diagnoses were agreed to have increased by 7.4 to 11…”

Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study.

“…Fear of going to a hospital and exposure to a possible risk of infection appeared to be a critical factor in this decline as other publications suggests. 12 In accordance with our hypothesis, emergent visits increased by 5.91% and non-emergent visits decreased by 6.58%, however, the decline of the non-emergent visits were not as signi cant as expected. A decrease of less than 10 per cent, although signi cant (p<0.001), indicates that patients with non-emergent conditions do not understand the severity of their pathology, and continue to present at ED.…”

“…This reduction in the number of OE coincides with a publication that studied the number of visits to the ED globally during a similar period in Norway where the reduction of visits varied from 21% to 39% depending on the studied week, 10 and with other publications that described the effects of the pandemic on OE in speci c hospitals where the reduction of visits decreased more than 50%. [11][12][13] . Fear of going to a hospital and exposure to a possible risk of infection appeared to be a critical factor in this decline as other publications suggests.…”

Emergency treatment of ophthalmologic diseases during the first phase of SARS-CoV2 pandemic in a tertiary referral center in Germany – the COVID-DETOUR questionnaire study

“…We included patients with an acute need for treatment as an inpatient, regardless of whether surgery was indicated or not. This has to be considered when comparing the numbers from this setting to other studies reporting on emergency department visits (8,9) or ophthalmic surgical care (10).…”