• Davide Golinelli, Francesca Campinoti, Francesco Sanmarchi, Simona Rosa, Michelle Beleffi, Gabriele Farina, Andrea Tampieri, Maria Pia Fantini, Fabrizio Giostra, and Luca Santi.
• Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum - University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy. Electronic address: davide.golinelli@unibo.it.
• Am J Emerg Med. 2021 Dec 1; 50: 222622-26.

BackgroundEvidence is lacking about the impact of subsequent COVID-19 pandemic waves on Emergency Departments (ED). We analyzed the differences in patterns of ED visits in Italy during the two pandemic waves, focusing on changes in accesses for acute and chronic diseases.MethodsWe conducted a retrospective study using data from a metropolitan area in northern Italy that includes twelve ED. We analyzed weekly trends in non-COVID-19 ED visits during the first (FW) and second wave (SW) of the pandemic. Incidence rate ratios (IRRs) of triage codes, patient destination, and cause-specific ED visits in the FW and SW of the year 2020 vs. 2019 were estimated using Poisson regression models.Main FindingsWe found a significant decrease of ED visits by triage code, which was more marked for low priority codes and during the FW. We found an increased share of hospitalizations compared to home discharges both in the FW and in the SW. ED visits for acute and chronic conditions decreased during the FW, ranging, from -70% for injuries (IRR = 0.2862, p < 0.001) to -50% and - 60% for ischemic heart disease and heart failure.ConclusionsThe two pandemic waves led to a selection of patients with higher and more urgent needs of acute hospital care. These findings should lead to investigate how to improve systems' capacity to manage changes in population needs.Copyright © 2021 Elsevier Inc. All rights reserved.

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