The impact of COVID-19 related national lockdown on ophthalmic emergency in Italy: A multicenter study

Maria L Salvetat, Carlo Salati, Patrizia Busatto, Marco Zeppieri, Maria L Salvetat, Carlo Salati, Patrizia Busatto, Marco Zeppieri

Abstract

Purpose: To assess ocular pathologies admitted to Italian Emergency Eye Departments (EEDs) during the COVID-19 pandemic national lockdown in 2020 in comparison with the same period in 2019.

Methods: Electronic records of all patients presenting at EEDs of two tertiary-care Eye Centers during the COVID-19 national lockdown in Italy (March 10-May 3, 2020) were compared with the equivalent period in 2019. Main outcomes were patient age, gender, and diagnoses. Statistical analysis included unpaired Student t-tests, Poisson regression, and chi-square test.

Results: Overall EED visits significantly decreased by 54.1% during the 2020 lockdown compared to 2019 (851 vs 1854, p < 0.001). During lockdown, patients showed comparable mean age (52.8 years in 2020 vs 53.3 years in 2019, p = 0.52) and significant male gender bias (61.1% in 2020 vs 55.8% in 2019, p < 0.0001). The most frequent pathologies were eye inflammations, trauma-related incidents, and spontaneous acute vitreous detachment. Patients with inflammation, headache/hemicrania, and spontaneous subconjunctival hemorrhages were significantly less, whereas those with trauma-related diagnoses were significantly higher during the lockdown as compared with 2019 (p < 0.05). The proportion of non-urgent visits decreased from 17% in 2019 to 8% in 2020 (p < 0.001).

Conclusions: During the 2020 lockdown, there was a significant reduction of accesses to EED, especially for non-urgent pathologies. Potentially visual function threatening conditions, such as trauma-related pathologies, retinal detachment or ruptures, and wet AMD, showed lower number of cases but higher or stable proportion relative to the total caseload, suggesting a correct and efficient access to ophthalmic health care during the pandemic period.

Keywords: COVID-19; SARS-CoV-2; eye emergency; lockdown; pandemic.

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Bar chart showing the average number of patients presenting to the Emergency Eye Department per week during the COVID-19 related pandemic lockdown in Italy (March 10–May 3, 2020), compared to the equivalent period in 2019.
Figure 2.
Figure 2.
(a) Bar chart of age distribution (number of cases in each age rank) of patients presenting to the Emergency Eye Department during the COVID-19 related pandemic lockdown in Italy (March 10–May 3, 2020), compared to the equivalent period in 2019. (b) Bar chart of gender distribution (% of total caseload) of patients presenting to the Emergency Eye Department during the COVID-19 related pandemic lockdown in Italy (March 10–May 3, 2020), compared to the equivalent period in 2019.
Figure 3.
Figure 3.
Bar chart of the most frequent diagnoses (as percentage of total caseload) of patients presenting to the Emergency Eye Department during the COVID-19 related pandemic lockdown in Italy (March 10–May 3, 2020), compared to the equivalent period in 2019. *Statistically significant difference between groups.
Figure 4.
Figure 4.
Bar chart of the percentages of patients presenting to the Emergency Eye Department during the COVID-19 related pandemic lockdown in Italy (March 10–May 3, 2020) and the equivalent period in 2019 classified as having urgent and non-urgent cases.

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