The impact of the COVID-19 pandemic on otolaryngologic emergency department visits at two major NYC hospital systems

Abstract

Purpose Since the COVID-19 pandemic began, emergency departments (ED) across the country have seen a significant decrease in patient visits. We aim to evaluate the impact of COVID-19 on ED visits for acute otolaryngologic complaints in New York City, one of the first epicenters of the pandemic in the US. Materials and methods We conducted a retrospective study of patients who presented to the ED with a primary diagnosis of an acute otolaryngologic complaint between March 1 and May 31 in 2019 and 2020. This was a multicenter study, including two tertiary care hospital systems encompassing Manhattan, Bronx, Queens, and Long Island. Results A total of 10,162 patients were identified. Significantly fewer patients presented to the ED for acute otolaryngology complaints in 2020 (7332 vs 2830, p < 0.001). The rate of total otolaryngology-related ED visits was decreased by a factor of 0.635 (95% CI 0.6079 to 0.6634). In a subgroup analysis of each individual diagnosis, there was a significant decrease in rate of ED visits for 13 out of 18 diagnoses, including for life-threatening conditions, such as anaphylaxis. There was no significant difference based on which borough in New York City. Pediatric patients (age 0–17) were more significantly impacted by the pandemic compared to other age groups. Conclusion The COVID-19 pandemic has led to a reduction in the utilization of ED for acute otolaryngologic complaints, including those requiring emergent management, and an even more significant reduction in the pediatric population. Healthcare providers should encourage patients to seek appropriate care, particularly for those illnesses with significant associated morbidity and mortality.

Global Otitis Media Incidence Changes During the COVID Pandemic: Systematic Review and Meta‐Analysis

“…All studies were retrospective chart reviews with exception of one ecological study. Nineteen studies included pre and during-lockdown OM diagnoses [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and 5 included OM tympanostomy tube surgery numbers (either tympanostomy or myringotomy). [28][29][30][31][32] Two of the 19 studies that contained OM incidence data also included OM antibiotic prescription numbers.…”

“…According to assessment by the JBI Critical Appraisal Tool for Prevalence Studies, 15 studies were graded as having low risk of bias. 10,12,13,15,[19][20][21][22][23][24]26,27,29,32 The studies were graded as having some risk of bias, with seven studies had only one category marked as unclear, 11,14,16,28,30,31,41 two studies had two unclear categories, 18,25 and one study had three categories marked as unclear. 17 One study was graded as having a high risk of bias 42 with three categories marked as high risk.…”

“…Although presentation of COVID‐19 in hospital and outpatient settings continued to increase, presentation of other viral infections decreased 9 . Studies from various countries showed that the prevalence of OM decreased compared with pre‐pandemic prevalence 10–32 . Lockdowns, school closures, and social distancing caused decreases in the incidence of various viral infections including viral OM.…”

Stellungnahme der Wissenschaftlichen Fachgesellschaft und des Berufsverbandes zur Notfallversorgung in der Hals-Nasen-Ohren-Heilkunde

“…Ein drastischer Rückgang an Fallzahlen in den Notfallambulanzen der HNO-Heilkunde, aber auch anderer Fächer, erfolgte im Zuge der Corona-Pandemie und der Lockdown-Maßnahmen. Dieser Rückgang hat sich jedoch nach der Pandemie wieder ausgeglichen [28,29,30,31,32,33,34,35].…”