Sociodemographic changes in emergency department visits due to alcohol during COVID-19

Myran, Daniel T.; Cantor, Nathan; Pugliese, Michael; Hayes, Tavis; Talarico, Robert; Kurdyak, Paul; Qureshi, Danial; Tanuseputro, Peter

doi:10.1016/j.drugalcdep.2021.108877

Cited by 20 publications

(29 citation statements)

References 19 publications

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“…As an illustration, during the pandemic, patients have been found to have delayed presentations to hospital for several non-COVID urgent illnesses (e.g., stroke, acute coronary syndrome, intoxications, etc. ), often due to patients' perception to strictly adhere to public health interventions and/or fearing risk of contracting COVID-19 in hospitals [7][8][9]. Healthcare professionals and health systems have operated under considerable strain and may have struggled to maintain usual standards-of-care for patients admitted with non-COVID illnesses, while also having adapting to meet expanded care needs for patients with COVID-19 [10].…”

Section: Introductionmentioning

confidence: 99%

Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis

Lau

Dhanoa²,

Cheema³

et al. 2022

PLoS ONE

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Background As the Coronavirus Disease-2019 (COVID-19) pandemic continues, healthcare providers struggle to manage both COVID-19 and non-COVID patients while still providing high-quality care. We conducted a systematic review/meta-analysis to describe the effects of the COVID-19 pandemic on patients with non-COVID illness and on healthcare systems compared to non-pandemic epochs. Methods We searched Ovid MEDLINE/EMBASE/Cochrane Database of Systematic Reviews/CENTRAL/CINAHL (inception to December 31, 2020). All study types with COVID-pandemic time period (after December 31, 2019) with comparative non-pandemic time periods (prior to December 31, 2019). Data regarding study characteristics/case-mix/interventions/comparators/ outcomes (primary: mortality; secondary: morbidity/hospitalizations/disruptions-to-care. Paired reviewers conducted screening and abstraction, with conflicts resolved by discussion. Effect sizes for specific therapies were pooled using random-effects models. Risk of bias was assessed by Newcastle-Ottawa Scale, with evidence rating using GRADE methodology. Results Of 11,581 citations, 167 studies met eligibility. Our meta-analysis showed an increased mortality of 16% during the COVID pandemic for non-COVID illness compared with 11% mortality during the pre-pandemic period (RR 1.38, 95% CI: 1.28–1.50; absolute risk difference: 5% [95% CI: 4–6%], p<0.00001, very low certainty evidence). Twenty-eight studies (17%) reported significant changes in morbidity (where 93% reported increases), while 30 studies (18%) reported no significant change (very low certainty). Thirty-nine studies (23%) reported significant changes in hospitalizations (97% reporting decreases), while 111 studies (66%) reported no significant change (very low certainty). Sixty-two studies (37%) reported significant disruptions in standards-to-care (73% reporting increases), while 62 studies (37%) reported no significant change (very low certainty). Conclusions There was a significant increase in mortality during the COVID pandemic compared to pre-pandemic times for non-COVID illnesses. When significant changes were reported, there was increased morbidity, decreased hospitalizations and increased disruptions in standards-of-care. Systematic review registration PROSPERO CRD42020201256 (Sept 2, 2020).

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Section: Introductionmentioning

confidence: 99%

Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis

Lau

Dhanoa²,

Cheema³

et al. 2022

PLoS ONE

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“…No significantly consistent change on this matter could have been observed, which reflects different coping mechanisms that can be used [17]. Several papers regarding a similar topic also showed that in some countries alcohol-related attendances were higher [18], but in others lower [19]. Poland did not implement any alcohol-related restrictions during the COVID-19 pandemic as seen in other countries with declined ED attendances [19].…”

Section: Discussionmentioning

confidence: 97%

The impact of the COVID-19 pandemic on alcohol-related emergency department visits in a large European city

Cholerzyńska

Zasada²,

Konieczka³

et al. 2022

Medical Research Journal

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Introduction:The COVID-19 (Coronavirus infectious disease 2019) pandemic has caused global behavioural changes due to the need to remain in quarantine by large groups of the population. Earlier work on the effects of other epidemics on the human psyche has revealed a possible increase in the number of people who abuse alcohol as a method of coping with mental stress. Despite this, the studies on the COVID-19 pandemic have not shown a clear correlation between lockdowns and quarantines and an increase in alcohol consumption. This study focused on examining the impact of the pandemic on the number of alcohol-related attendances in the Emergency Department in Poznan (Poland). Material and methods:The periods of one year before the pandemic (control trial) and the first year of the COVID-19 pandemic (study group) were analysed retrospectively using the data of ED patients who were under the documented influence of alcohol. Total number, alcohol concentration, waiting time for a medical examination, the patient's aggressive behaviour, length of stay in the ED, the need for additional examinations, suturing wounds or endotracheal intubation were analysed.Results: 954 patients were identified, which constituted 2.9% of all patients admitted to the ED during this period (the total number of patients admitted was 33510). During the control period, the total number of ED admissions was 30388 and 794 (2.6%) of them were in the control group. The median body alcohol concentration was 2.6%%. It has been shown that during the pandemic more women and fewer men under the influence of alcohol were admitted to the ED (212 (22.2%) females and 742 (77.8%) males) than in the pre-pandemic period [135 (17.0%) females and 659 (83.0%) males]. Additional examinations were performed less frequently (84.1% vs. 73.9%; p = 0.00000) and patients were admitted to other departments more often (25.7% vs. 40.9%; p = 0.00000). Other examined parameters did not change significantly. Conclusions:The study shows an increase in the number of patients under the influence of alcohol during the pandemic presenting to the ED and a noticeable change in management patterns' variables such as shorter LOW, fewer performed laboratory tests and more admissions to wards. However, this data requires further analysis and comparison with studies from other centres to draw more general conclusions.

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“…The relationship between emergency service utilisation and alcohol during the pandemic is likely to be highly context specific. It will also hugely depend on the pattern of restrictions in place as illustrated by findings from North America [ 26 , 27 ] outlined earlier and evidence from South Africa finding reduced emergency attendances during total and partial alcohol sales bans [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fear of infection and a desire to avoid burdening health services may explain these falls; though health behaviours, including alcohol consumption may also be a factor. In Canada, alcohol‐related visits at accident and emergency departments decreased at the beginning of the pandemic but to a lesser extent than other visits [ 26 ]. In New York City, during the initial COVID‐19 peak in spring 2020, hospital visits for alcohol withdrawal increased while those for alcohol use decreased [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Lockdown and licensed premises: COVID‐19 lessons for alcohol policy

Fitzgerald

Manca

Uny

et al. 2021

Drug and Alcohol Review

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Introduction. The COVID-19 pandemic necessitated unprecedented changes in alcohol availability, including closures, curfews and restrictions. We draw on new data from three UK studies exploring these issues to identify implications for premises licensing and wider policy. Methods. (i) Semi-structured interviews (n = 17) with licensing stakeholders in Scotland and England reporting how COVID-19 has reshaped local licensing and alcohol-related harms; (ii) semi-structured interviews (n = 15) with ambulance clinicians reporting experiences with alcohol during the pandemic; and (iii) descriptive and time series analyses of alcohol-related ambulance callouts in Scotland before and during the first UK lockdown (1 January 2019 to 30 June 2020). Results. COVID-19 restrictions (closures, curfews) affected on-trade premises only and licensing stakeholders highlighted the relaxation of some laws (e.g. on takeaway alcohol) and a rise in home drinking as having long-term risks for public health. Ambulance clinicians described a welcome break from pre-pandemic mass public intoxication and huge reductions in alcohol-related callouts at night-time. They also highlighted potential long-term risks of increased home drinking. The national lockdown was associated with an absolute fall of 2.14 percentage points [95% confidence interval (CI) À3.54, À0.74; P = 0.003] in alcohol-related callouts as a percentage of total callouts, followed by a daily increase of +0.03% (95% CI 0.010, 0.05; P = 0.004). Discussion and Conclusions. COVID-19 gave rise to both restrictions on premises and relaxations of licensing, with initial reductions in alcohol-related ambulance callouts, a rise in home drinking and diverse impacts on businesses. Policies which may protect on-trade businesses, while reshaping the night-time economy away from alcohol-related harms, could offer a 'win-win' for policymakers and health advocates.

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Sociodemographic changes in emergency department visits due to alcohol during COVID-19

Cited by 20 publications

References 19 publications

Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis

Non-COVID outcomes associated with the coronavirus disease-2019 (COVID-19) pandemic effects study (COPES): A systematic review and meta-analysis

The impact of the COVID-19 pandemic on alcohol-related emergency department visits in a large European city

Lockdown and licensed premises: COVID‐19 lessons for alcohol policy

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