[Analysis of the evolution of patients attended in Spanish emergency departments during the first wave of the pandemic]

To describe the number of visits (total and per COVID-19) attended by the Spanish hospital emergency departments (EDs) during the first wave of the pandemic (March-April 2020) compared to the same period in 2019, and to calculate the quantitative changes in healthcare activity and investigate the possible influence of hospital size and COVID-19 seroprevalence. Method: Cross-sectional study that analyzes the number of visits to Spanish public EDs, reported through a survey of ED chiefs during the study periods. Changes in healthcare activity were described in each autonomous community and com-pared according to hospital size and the provincial impact of the pandemic.

There was a very significant decrease in the number of ED visits during the first pandemic wave, although this decrease cannot be explained solely by the local incidence of the pandemic. Fundamento: Describir el número de consultas, total y por COVID-19, atendidas en servicios de urgencias hospitalarios (SUH) españoles durante marzo y abril de 2020, compararlo con el mismo periodo del año anterior, cuantificar el cambio de actividad asistencial e investigar la posible influencia del tamaño del hospital y de la seroprevalencia provincial de COVID-19. Métodos: Estudio transversal. Se envió una encuesta a todos los responsables de SUH españoles del sistema público de salud sobre el número de consultas atendidas durante marzo y abril de 2019 y de 2020. Se calculó el cambio de actividad asistencial por comunidad autónoma, y se comparó en función del tamaño del hospital y del impacto provincial de la pandemia. Resultados: Participaron el 66% de los 283 SUH. Se observó un descenso del 49,2% de las consultas totales (solo los SUH de Castilla-La Mancha mostraron un descenso inferior al 30%) y del 60% de las consultas no-COVID-19 (solo los SUH de Asturias y Extremadura mostraron un descenso inferior al 50%). el cambio de actividad asistencial no difirió en función del tamaño del hospital, pero sí en relación al impacto provincial de la pandemia, con una correlación directa respecto al descenso de actividad no-COVID-19 (a mayor impacto, mayor descenso; R2 = 0,05; p = 0,002) e inversa en relación a la actividad global (a mayor impacto, menor descenso; R2 = 0,05; p = 0,002). Conclusiones: Durante la primera ola pandémica descendió el número de consultas en los SUH, si bien dicho descenso no se explica únicamente por la incidencia local de la pandemia.

A total of 187 (66?%) of the 283 Spanish EDs participated in the study. The total number of patients attended de-creased to 49.2?% (<?30?% in the Castilla-La Mancha region), with a 60?% reduction in non-COVID-19 patients (reduction <?50?% in the regions of Asturias and Extremadura). While there were no differences in changes of healthcare activity according to the size of the hospital, there were differences in relation to the provincial impact of the pandemic, with a direct correla-tion related to the decrease in non-COVID-19 activity (the greater the impact, the greater the decrease; R2?=?0.05; p?=?0.002) and an inverse correlation to the overall activity (the greater the impact, the lesser the decrease; R2?=?0.05; p?=?0.002).