[Skip to Content]

Claim CME

Emergency Medicine

Hospital Volumes of 5 Medical Emergencies in the COVID-19 Pandemic in 2 US Medical Centers

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Internal Medicine

Published Online: October 26, 2020

Research Letter

Article Information and Disclosures

Hriday P. Bhambhvani, BS¹;

Adrian J. Rodrigues, BA¹;

Jonathan S. Yu, BS²;

James B. Carr II, MD²;

Melanie Hayden Gephart, MD, MAS¹

Author Affiliations

¹Department of Neurosurgery, Stanford University Medical Center, Stanford, California
²Weill Cornell Medical College, New York, New York

Read article on JAMA Network

Read Article Claim CME

Amid the coronavirus disease 2019 (COVID-19) pandemic, there have been anecdotal reports of a reduction in non–COVID-19 emergent diseases, including ischemic stroke¹ and myocardial infarction (MI),²^,3 and a general drop in emergency department volumes.⁴ The concern is that patients, wary of contact with individuals with COVID-19, are reluctant to seek care, even in the face of acute, life-threatening conditions. Using data from 2 academic medical centers, we assessed the association of the COVID-19 pandemic with the incidence of 5 medical emergencies: acute MI, ischemic stroke, nontraumatic subarachnoid hemorrhage (ntSAH), ectopic pregnancy, and appendicitis.

Claim CME

Sign in to take quiz and track your certificates

Buy This Activity

Article Information

Accepted for Publication: July 2, 2020.

Published Online: October 26, 2020. doi:10.1001/jamainternmed.2020.3982

Corresponding Author: Melanie Hayden Gephart, MD, MAS, Brain Tumor Center, Department of Neurosurgery, Stanford University Medical Center, 300 Pasteur Dr, Palo Alto, CA 94305 (mghayden@stanford.edu).

Author Contributions: Mr Bhambhvani and Dr Hayden Gephart had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Bhambhvani, Rodrigues, Yu, Hayden Gephart.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Bhambhvani, Rodrigues, Yu.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Bhambhvani, Rodrigues, Yu.

Administrative, technical, or material support: Carr, Hayden Gephart.

Study supervision: Carr, Hayden Gephart.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank Ryka Sehgal, BA (Weill Cornell Medical College), for support with protocol submission (no compensation), and Steven E. Flores, BS (Weill Cornell Medicine), for support with research informatics (no compensation).

References

Morelli N , Rota E , Terracciano C , et al. The baffling case of ischemic stroke disappearance from the casualty department in the COVID-19 era. Eur Neurol. 2020;83(2):213-215. doi:10.1159/000507666 PubMed Google Scholar Crossref

Krumholz H . Where have all the heart attacks gone? New York Times. April 6, 2020. Accessed September 17, 2020. https://www.nytimes.com/2020/04/06/well/live/coronavirus-doctors-hospitals-emergency-care-heart-attack-stroke.html

Solomon MD , McNulty EJ , Rana JS , et al. The Covid-19 pandemic and the incidence of acute myocardial infarction. N Engl J Med. 2020;383:691-693. doi:10.1056/NEJMc2015630 PubMed Google Scholar Crossref

Wong LE , Hawkins JE , Langness S , Murrell KL , Iris P , Sammann A . Where are all the patients? addressing Covid-19 fear to encourage sick patients to seek emergency care. NEJM Catalyst. Published online May 14, 2020. doi:10.1056/CAT.20.0193 Google Scholar

Bernal JL , Cummins S , Gasparrini A . Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2017;46(1):348-355. doi:10.1093/ije/dyw098 PubMed Google Scholar

Griffin S . Covid-19: “huge rise” in deaths at home is not fully explained by virus, say experts. BMJ. 2020;369:m2115. doi:10.1136/bmj.m2115 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.