• Minu Agarwal, Amar Udare, Michael Patlas, Milita Ramonas, Amer A Alaref, Radu Rozenberg, Donald L Ly, Dmitry S Golev, Ken Mascola, and Christian B van der Pol.
• Departm=ent of Radiology (Agarwal, Udare, Patlas, Ramonas, Mascola, van der Pol), Hamilton Health Sciences; Department of Radiology (Agarwal, Udare, Patlas, Ramonas, van der Pol), McMaster University, Hamilton, Ont.; Thunder Bay Regional Health Sciences Centre (Alaref, Rozenberg); Northern Ontario School of Medicine (Alaref, Rozenberg), Thunder Bay, Ont.; Mackenzie Health (Ly), Richmond Hill, Ont.; Orillia Soldiers' Memorial Hospital (Golev), Orillia, Ont.
• CMAJ Open. 2020 Jul 1; 8 (3): E568-E576.

BackgroundThe effect of the coronavirus disease 2019 (COVID-19) pandemic on new or unexpected radiologic findings in the emergency department (ED) is unclear. The aim of this study was to determine the effect of the COVID-19 pandemic on the number of computed tomography (CT) critical test results in the ED.MethodsWe performed a retrospective observational study of ED CT usage at 4 Ontario hospitals (1 urban academic, 1 northern academic, 1 urban community and 1 rural community) over 1 month during the COVID-19 pandemic (April 2020) and over the same month 1 year earlier (April 2019; before the pandemic). The CT findings from 1 of the 4 hospitals, Hamilton Health Sciences, were reviewed to determine the number of critical test results by body region. Total CT numbers were compared using Poisson regression and CT yields were compared using the χ2 test.ResultsThe median number of ED CT examinations per day was markedly lower during the COVID-19 pandemic than before the pandemic (82 v. 133, p < 0.01), with variation across hospitals (p = 0.001). On review of 1717 CT reports from Hamilton Health Sciences, fewer critical test results were demonstrated on CT pulmonary angiograms (43 v. 88, p < 0.001) and CT examinations of the head (82 v. 112, p < 0.03) during the pandemic than before the pandemic; however, the yield of these examinations did not change. Although the absolute number of all CT examinations with critical test results decreased, the number of CT examinations without critical results decreased more, resulting in a higher yield of CT for critical test results during the pandemic (46% [322/696] v. 37% [379/1021], p < 0.01).InterpretationEmergency department CT volumes markedly decreased during the COVID-19 pandemic, predominantly because there were fewer examinations with new or unexpected findings. This suggests that COVID-19 public information campaigns influenced the behaviours of patients presenting to the ED.Copyright 2020, Joule Inc. or its licensors.

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