Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study

Carolin Hoyer, Niklas Grassl, Kathrin Bail, Patrick Stein, Anne Ebert, Michael Platten, Kristina Szabo Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, GermanyCorrespondence: Carolin HoyerDepartment of Neur...

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Autores principales:	Hoyer C, Grassl N, Bail K, Stein P, Ebert A, Platten M, Szabo K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	pandemics covid-19 emergency neurology Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/41c9ca3fd45c4d1e901223d8e9df6446
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spelling	oai:doaj.org-article:41c9ca3fd45c4d1e901223d8e9df64462021-12-02T10:33:50ZChanges in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study1178-2021https://doaj.org/article/41c9ca3fd45c4d1e901223d8e9df64462020-09-01T00:00:00Zhttps://www.dovepress.com/changes-in-demographic-and-diagnostic-spectra-of-patients-with-neurolo-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Carolin Hoyer, Niklas Grassl, Kathrin Bail, Patrick Stein, Anne Ebert, Michael Platten, Kristina Szabo Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, GermanyCorrespondence: Carolin HoyerDepartment of Neurology, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68 167 Mannheim, GermanyTel +49-621-383-5268Fax +49-621-383-3807Email carolin.hoyer@umm.deObjective: To analyse the characteristics of patients with neurological complaints seeking evaluation in an interdisciplinary emergency department (ED) during the rise of the COVID-19 pandemic in Germany.Methods: In this retrospective study, data on the number of ED presentations due to neurological complaints in weeks 1– 15/2020 were collected. In addition, hospital chart data of patients referred for neurological evaluation during weeks 12– 15/2020 when the pandemic began impacting on public life in Germany were analysed regarding demographic information, chief complaints, modes of presentation and disposition and ED discharge diagnosis. Both data sets were compared to respective periods from 2017.Results: During the surge of COVID-19, we found a significant decrease of the total number of neurological ED patients by 47.6%. Comparing weeks 12– 15 of 2017 and 2020, we found a decrease in the number of patients of < 30 years (p< 0.001) and an increase of those 70 years (p< 0.001). A higher proportion of patients were admitted to escalated care (p=0.03), and fewer patients were discharged against medical advice (p< 0.001). In addition, the ratio of less acute diagnoses (eg, benign headaches) declined significantly.Conclusion: Our findings suggest that the pandemic has contributed to a – potentially transient – reframing of laypeople’s perception of urgency and necessity for emergency presentation. The establishment and promotion of health-care structures and services like telemedical consultations and the creation of safe ED environments will be essential to enable adequate delivery of care in potential future waves of the pandemic.Keywords: pandemics, COVID-19, emergency neurologyHoyer CGrassl NBail KStein PEbert APlatten MSzabo KDove Medical Pressarticlepandemicscovid-19emergency neurologyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 2221-2227 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	pandemics covid-19 emergency neurology Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	pandemics covid-19 emergency neurology Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Hoyer C Grassl N Bail K Stein P Ebert A Platten M Szabo K Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study
description	Carolin Hoyer, Niklas Grassl, Kathrin Bail, Patrick Stein, Anne Ebert, Michael Platten, Kristina Szabo Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, GermanyCorrespondence: Carolin HoyerDepartment of Neurology, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68 167 Mannheim, GermanyTel +49-621-383-5268Fax +49-621-383-3807Email carolin.hoyer@umm.deObjective: To analyse the characteristics of patients with neurological complaints seeking evaluation in an interdisciplinary emergency department (ED) during the rise of the COVID-19 pandemic in Germany.Methods: In this retrospective study, data on the number of ED presentations due to neurological complaints in weeks 1– 15/2020 were collected. In addition, hospital chart data of patients referred for neurological evaluation during weeks 12– 15/2020 when the pandemic began impacting on public life in Germany were analysed regarding demographic information, chief complaints, modes of presentation and disposition and ED discharge diagnosis. Both data sets were compared to respective periods from 2017.Results: During the surge of COVID-19, we found a significant decrease of the total number of neurological ED patients by 47.6%. Comparing weeks 12– 15 of 2017 and 2020, we found a decrease in the number of patients of < 30 years (p< 0.001) and an increase of those 70 years (p< 0.001). A higher proportion of patients were admitted to escalated care (p=0.03), and fewer patients were discharged against medical advice (p< 0.001). In addition, the ratio of less acute diagnoses (eg, benign headaches) declined significantly.Conclusion: Our findings suggest that the pandemic has contributed to a – potentially transient – reframing of laypeople’s perception of urgency and necessity for emergency presentation. The establishment and promotion of health-care structures and services like telemedical consultations and the creation of safe ED environments will be essential to enable adequate delivery of care in potential future waves of the pandemic.Keywords: pandemics, COVID-19, emergency neurology
format	article
author	Hoyer C Grassl N Bail K Stein P Ebert A Platten M Szabo K
author_facet	Hoyer C Grassl N Bail K Stein P Ebert A Platten M Szabo K
author_sort	Hoyer C
title	Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study
title_short	Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study
title_full	Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study
title_fullStr	Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study
title_full_unstemmed	Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study
title_sort	changes in demographic and diagnostic spectra of patients with neurological symptoms presenting to an emergency department during the covid-19 pandemic: a retrospective cohort study
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/41c9ca3fd45c4d1e901223d8e9df6446
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Changes in Demographic and Diagnostic Spectra of Patients with Neurological Symptoms Presenting to an Emergency Department During the COVID-19 Pandemic: A Retrospective Cohort Study

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