Impact of Covid-19 in the Emergency Department

Study Overview
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Brief Summary
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To investigate the effects of lockdown in the Emergency Department in a tertiary health care hospital, Nuremberg, Germany.

Detailed Description
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To investigate the effect of the first lockdown caused by the pandemic of Covid-19 in a tertiary health care hospital. Klinikum Nuremberg is one of the largest tertiary health care hospitals in Germany with two locations in Nuremberg. In the north department, around 150 outcome patients visit the Emergency Department every day. During the pandemic in 2020 the capacities of the hospitals were saved for the patients with Covid-19. A decrease of patients presented in the ED was noticed. Controlling system and patient management provided the number of cases and correlated with the same period of time one year ago, before the pandemic. For the classification of severity of diseases, different clinical diseases with severity scores were analyzed. Following diseases and scores were evaluated: Pancreatitis -- > ranson score; ACS (acute coronary syndrome) --> Grace-Score; Pulmonary Embolism -- > sPESI (simplified Pulmonary Embolism Severity Index); Diverticulitis --> CDD (Classification of Diverticular Disease); Pneumonia -> crb65 (Confusion- Respiratory rate- Blood pressure- age ≥ 65 years);

Official Title
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Impact of Covid-19 in the Emergency Department in a Tertiary Care Hospital, Nuremberg-Germany

Conditions
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COVID-19

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Only patients who presented in the ED. Exclusion Criteria: none
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| experimental<br>patients during lockdown | |
| control group<br>patients before lockdown | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ranson score | clinical severity index of pancreatitis. Estimates mortality of patients with pancreatitis, based on initial and 48-hour lab values. Min. 0 - Max. 11 points. | through study completion, an average of 1 year | 
| Grace-Score | clinical severity index of ACS. Estimates admission untill 6 month mortality for patients with acute coronary syndrome. 108 points: low risk. Over 141-372 points: high risk. | through study completion, an average of 1 year | 
| sPESI | clinical severity index of pulmonary embolism. Predicts 30-day outcome of patients with pulmonary embolism. Min 0 points- max. 6 points | through study completion, an average of 1 year | 
| crb65 | The CRB-65-score is a clinical score that is used to estimate the severity of community-acquired pneumonias. The score corresponds to the statistical probability of patients dying because of pneumonia. Min 0 points - highest score 4 points. | through study completion, an average of 1 year | 
| CDD | clinical severity index of diverticulitis. Min 0 - max. 4 | through study completion, an average of 1 year |