Characteristics and countermeasures of emergency critically ill patients at different stages of Coronavirus Disease 2019 epidemics

  Objective  To analyze the characteristic changes of critically ill patients in emergency department of municipal hospital during the early stage (emergency response stage) and regular prevention and control stages of the Coronavirus Disease 2019 (COVID-19) epidemics, and to propose the strategies.

  Methods  The changes of number of critically ill patients in the emergency department of our hospital within 1 year since the initiation of emergency response to the epidemic (January 26, 2020 to January 25, 2021) was counted compared with the same period before the emergency response(January 26, 2019 to January 25, 2020) in Yangzhou City of Jiangsu Province. The proportion changes of hospitalizations and deaths were observed. The disease types of critically ill patients at different stages before and after the epidemic were compared to analyze possible causes and formulate countermeasures.

  Results  The number of critically ill patients in the emergency room of our hospital within one year of the start of emergency response was 15 002, and was 15 139 in the same period of emergency response before. During the epidemic, there was no significant differences in the proportions of hospitalizations and deaths of critically ill patients compared with the same period of emergency response before (P>0.05). The proportion of critically ill patients with respiratory system diseases and poisoning in early stage of the epidemic(from January 26 to March 26, 2020) decreased, while the proportions of mental emergency and unclassified diseases increased compared with the same period of the previous year(January 26 to March 26, 2019)(P < 0.05). The proportions of respiratory diseases and poisoning in emergency rooms during the normal epidemic control period (March 27, 2020 to January 25, 2021) were lower than those before the normal epidemic control period (March 27, 2019 to January 25, 2020), and the proportions of unclassified diseases were higher than those before the normal epidemic control period(P < 0.05).

  Conclusion  During the COVID-19 epidemic, emergency rooms of prefecture-level hospitals should focus on the emergency treatment of critical diseases. It is suggested to strengthen the abilities to deal with multi-system diseases and difficult critical diseases, while more attention should be paid to patients with mental emergency in the early clinical stage of the epidemic.