[Acute care during the first corona wave. Minor health damage for patients without covid-19 in a Dutch hospital].

Goal: To study the effect of the first COVID-19 wave in combination with the lockdown on acute care in the Netherlands.

Design: Retrospective cohort study METHOD: For this study, data was collected from patients who visited the emergency department (ED) and Cardiac Care Unit of Noordwest Ziekenhuisgroep in Alkmaar and Den Helder. This data collection took place from 1 February to 28 June in 2019 and during the same period in 2020. The number of visits per day was investigated. The outcome measures for hospital occupation were the number of admissions per day and the average length of stay. Outcome measures for health damage were length of stay and mortality.

Results: The number of ED visits fell by 27% during the lockdown. For the specialties of internal medicine and pulmonary medicine, the number of admissions from the ED was the same during the lockdown, but the length of stay was longer. For all other specialties, the number of admissions from the ED was lower during the lockdown, but the admission duration was the same. Mortality was higher and hospital stay longer for patients admitted to the specialties of internal medicine and pulmonary medicine. In all other specialisms studied, there was no higher mortality or longer hospital stay.

Conclusion: From the start of the lockdown, there was a sharp drop in the number of ED visits. The number of ED visits recovered slowly after this drop. For specialties that did not treat COVID-19 patients, hospital occupation was lower than usual. The number of admissions from the ED had decreased for these specialties. Based on the outcome measures length of stay and mortality, we were unable to find any indications of health damage as a result of the drop in admissions.