Abstract
ENT emergencies are heterogeneous and include infections, inflammatory
and traumatic conditions. We observed what appeared to be a dramatic
alteration in emergency presentations to our unit during the early phase
of 1st COVID-19 Lockdown in 2020.
Objective- This study compares pre COVID-19 presentations with
1st Lockdown presentations and examines the overall
numbers; conditions encountered and draw conclusions which may influence
future planning for ENT services.
Setting-Records for emergency ENT presentations to a regional centre
were examined for two comparable 61-day time periods.
Design and Participants -Presentations for April and May 2019
(pre COVID-19) were compared to April and May 2020
(1st Lockdown). Records were compared with regards to
overall numbers, demography, diagnosis and treatment. Admissions for
COVID-19 related airway interventions and admissions/attendances for
elective complications were excluded.
Results and conclusion -In the pre COVID-19 group, 649 emergency
presentations were recorded: 401 infection related cases, 90 epistaxis,
and 158 non-infectious/traumatic cases.
In the 1st Lockdown group, 254 emergency presentations
were recorded: 121 infection related cases, 56 epistaxis and 77
non-infectious/ traumatic cases.
Overall, there was a 61% reduction in emergency presentations during
the 1st Lockdown. Infectious cases reduced by 70%,
epistaxis reduced by 38% and non-infectious cases fell by 51%. All of
these differences were statistically significant (p value
<0.05). The infectious category showed the greatest reduction
in presentations and within this category the greatest change was
observed in Laryngeal infections (95%), facial cellulitis (84%) and
Tonsil infections (73%).
Key words: COVID-19, otorhinolaryngology, SARS-2 virus,
social distancing
- During 1st Lockdown, a significant overall reduction
in ENT emergency admissions was observed. This was greatest in the
infectious category but was not limited to this group.
- Reduced Infection presentations might have been expected as a result
of social distancing reducing community transmission. The observed
significant reductions in non-infectious emergencies are difficult to
explain.
- Reduced primary care triage may have been expected to lead to an
increase in emergency attendances but this was not observed.
- Fear of hospital attendance or the belief that the NHS was only
dealing with COVID-19 during the pandemic may have had a significant
effect on presentations.
- In the event of future pandemics, we propose that greater emphasis be
placed on ensuring that the public and primary care sectors are aware
of the continued availability of ENT services.