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Meta-Analysis
. 2022 Jun 8;18(1):58.
doi: 10.1186/s12992-022-00836-2.

Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses

Vahid Mogharab  1 , Mahshid Ostovar  2 , Jakub Ruszkowski  3   4 , Syed Zohaib Maroof Hussain  5 , Rajeev Shrestha  6 , Uzair Yaqoob  7 , Poorya Aryanpoor  2 , Amir Mohammad Nikkhoo  2 , Parasta Heidari  2 , Athar Rasekh Jahromi  2 , Esmaeil Rayatdoost  2 , Anwar Ali  8   9 , Farshid Javdani  2 , Roohie Farzaneh  10 , Aref Ghanaatpisheh  2 , Seyed Reza Habibzadeh  10 , Mahdi Foroughian  10 , Sayyed Reza Ahmadi  10 , Reza Akhavan  10 , Bita Abbasi  11 , Behzad Shahi  12 , Arman Hakemi  10 , Ehsan Bolvardi  10 , Farhad Bagherian  13 , Mahsa Motamed  14 , Sina Taherzadeh Boroujeni  14 , Sheida Jamalnia  15 , Amir Mangouri  16 , Maryam Paydar  2 , Neda Mehrasa  17 , Dorna Shirali  17 , Francesco Sanmarchi  18 , Ayesha Saeed  19 , Narges Azari Jafari  20 , Ali Babou  21 , Navid Kalani  22 , Naser Hatami  23
Affiliations
Meta-Analysis

Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses

Vahid Mogharab et al. Global Health. .

Abstract

Background: Apart from infecting a large number of people around the world and causing the death of many people, the COVID-19 pandemic seems to have changed the healthcare processes of other diseases by changing the allocation of health resources and changing people's access or intention to healthcare systems.

Objective: To compare the incidence of endpoints marking delayed healthcare seeking in medical emergencies, before and during the pandemic.

Methods: Based on a PICO model, medical emergency conditions that need timely intervention was selected to be evaluated as separate panels. In a systematic literature review, PubMed was quarried for each panel for studies comparing the incidence of various medical emergencies before and during the COVID-19 pandemic. Markers of failure/disruption of treatment due to delayed referral were included in the meta-analysis for each panel.

Result: There was a statistically significant increased pooled median time of symptom onset to admission of the acute coronary syndrome (ACS) patients; an increased rate of vasospasm of aneurismal subarachnoid hemorrhage; and perforation rate in acute appendicitis; diabetic ketoacidosis presentation rate among Type 1 Diabetes Mellitus patients; and rate of orchiectomy among testicular torsion patients in comparison of pre-COVID-19 with COVID-19 cohorts; while there were no significant changes in the event rate of ruptured ectopic pregnancy and median time of symptom onset to admission in the cerebrovascular accident (CVA) patients.

Conclusions: COVID-19 has largely disrupted the referral of patients for emergency medical care and patient-related delayed care should be addressed as a major health threat.

Keywords: COVID-19; Emergency department; Pandemic; SARS-COV-2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prisma Flow chart of study the National Institutes of Health (NIH) Quality Assessment Tool (Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies) was used to assess the quality of included studies and ranking studies in three categories of “good”, “fair”, and “poor”. (https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools)
Fig. 2
Fig. 2
Schematic of the relative change of different diseases after the pandemic. Relative change of (a) acute appendicitis, (b) ectopic pregnancy, (c) CVA, and (d) ACS incidence during COVID-19 pandemic
See this image and copyright information in PMC

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