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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

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.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

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).

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 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

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

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