COVID-19: how the pandemic impacted the emergency department and urgent surgical activity in a medium-size Italian hospital.

BackgroundsCOVID-19 has grown rapidly in Lombardy, particularly in the province of Bergamo. To deal with the pressure the pandemic has exerted on the Italian health system; many hospitals have had to reorganize their medical and surgical activities. The aim of this study was to evaluate how the pandemic influenced the emergency department and urgent surgical activity in a medium-size hospital in the province of Bergamo. MethodsIn this retrospective observational study, we analyzed the number of admissions to the medical and surgical Emergency Room and their severity compared with those in the same period in previous years (2011-2019). Admission in the medical and surgical department and urgent surgical operation was also assessed. ResultsFrom March 7th to April 5th, 2020, we observe a reduction in emergency department access (-53%) when compared with the corresponding period of previous years. The number of medical admissions was similar to the past years (+0.9%), we observed a drastic reduction of surgical patients (-82.5%). We experienced a significant increase in hospitalizations in the medical department (+359%) and a reduction of admission in the surgical department (-71.2%). ConclusionSARS-CoV2 disease has spread so suddenly and severely that it has stressed Italian health system, in particular the Lombard one. Our data show the rise of critical medical ER accesses and the significant expansion in hospitalisation in the medical department with the necessary hospital reorganisation to face COVID-19 emergency. We also observed a reduction in both surgical ER accesses and urgent surgical activity.