Impact of COVID-19 on Emergency Department Use for Genitourinary Injury
Lulu Wei, B.S., Isabelle Kaplan, M.S., Lakshay Khosla, B.A., Blaine Russ, B.S., Lauren Fink, M.D., Mahyar Kashani, M.D., Andrew Winer, M.D..
SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
BACKGROUND: The COVID-19 pandemic brought unprecedented change to the United States (US) healthcare system. We investigated how the epidemiology of US emergency department (ED) usage for pediatric and adult genitourinary (GU) injuries changed during the COVID-19 pandemic.
METHODS: We queried the National Electronic Injury Surveillance System for pediatric (<17 years old) and adult (≥18 years old) injuries to the pubic region from March to December of 2019 (pre-COVID-19) and 2020 (COVID-19). Adult and pediatric data were probability-weighted to produce national estimates and analyzed separately. We compared demographic and injury characteristics across the two time periods by χ2 test in SPSSv27.
RESULTS: Over the entire study period, GU injury accounted for 1% of pediatric and 0.4% of adult ED visits. During COVID-19, GU injuries decreased in adults (23,387 vs 28,090 cases) and children (19,684 vs 26,857 cases). Compared to pre-COVID-19, there were significant differences in age, race, diagnosis, disposition, location of injury and product causing injury (p<0.01, each). During COVID-19, there was a greater proportion of GU injuries in toddler and school age children; female children; White, Asian, and American Indian and Alaskan Native children; 24-34, 45-54, and 75-84 year olds; and Black and Asian adults. Proportion of GU avulsions, burns, and lacerations increased during COVID-19 for both adults and children. Cases treated and released increased during COVID-19 in children but decreased in adults.
CONCLUSIONS: COVID-19 decreased the volume of pediatric and adult GU injuries presenting to US EDs. Due to COVID-19-related concerns, patients may have altered health-seeking behaviors and avoided the ED unless they perceived a high severity of injury. Healthcare providers may have altered their care plans due to decreased capacity for non-COVID-19 related admissions.
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