Table 1.
Change in Diagnoses in Pre-COVID, Peri-COVID, and COVID Era in Academic and Community Hospitalsa
| Peri-COVID (2/9-3/16/20) vs COVID Period (3/17-4/21/20) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|
| Academic Hospitals |
Community Hospitals |
Overall |
|||||||
| 2/9/20-3/16/20 (N=16,181) | 3/17/20-4/21/20 (N=7779) | P | 2/9/20-3/16/20 (N=21,489) | 3/17/20-4/21/20 (N=10,867) | P | 2/9/20-3/16/20 (N=37,670) | 3/17/20-4/21/20 (N=18,646) | P | |
| Chief symptoms, no. (%) | |||||||||
| Abdominal pain | 1627 (10.1) | 806 (10.4) | .60 | 1739 (8.1) | 914 (8.4) | .50 | 3366 (8.9) | 1720 (9.2) | .38 |
| Back pain | 365 (2.3) | 163 (2.1) | .60 | 514 (2.4) | 267 (2.5) | .84 | 879 (2.3) | 430 (2.3) | .92 |
| Chest pain | 999 (6.2) | 553 (7.1) | .016b | 1156 (5.4) | 762 (7.0) | <.001b | 2155 (5.7) | 1315 (7.1) | <.001 |
| Other pain | 1579 (9.8) | 643 (8.3) | <.001b | 2008 (9.3) | 1099 (10.1) | .059 | 3587 (9.5) | 1742 (9.3) | .62 |
| Cough | 794 (4.9) | 564 (7.3) | <.001b | 1527 (7.1) | 637 (5.9) | .001b | 2321 (6.2) | 1201 (6.4) | .30 |
| Diarrhea | 148 (0.9) | 70 (0.9) | .99 | 200 (0.9) | 91 (0.8) | .59 | 348 (0.9) | 161 (0.9) | .62 |
| Earache or infection | 101 (0.6) | 48 (0.6) | >.99 | 363 (1.7) | 126 (1.2) | .002b | 464 (1.2) | 174 (0.9) | .003b |
| Fever | 846 (5.2) | 506 (6.5) | <.001b | 1193 (5.6) | 348 (3.2) | <.001b | 2039 (5.4) | 854 (4.6) | .001b |
| Gunshot wound | 0 (0) | 2 (0.0) | .30 | 3 (0.0) | 1 (0.0) | >.99 | 3 (0.0) | 3 (0.0) | .77 |
| Head injury or headache | 474 (2.9) | 181 (2.3) | .019b | 581 (2.7) | 271 (2.5) | .40 | 1055 (2.8) | 452 (2.4) | .023b |
| Laceration | 159 (1.0) | 99 (1.3) | .092 | 350 (1.6) | 264 (2.4) | <.001b | 509 (1.4) | 363 (1.9) | <.001 |
| Motor vehicle crash | 108 (0.7) | 45 (0.6) | .60 | 165 (0.8) | 55 (0.5) | .019b | 273 (0.7) | 100 (0.5) | .024b |
| Shortness of breath | 1038 (6.4) | 766 (9.8) | <.001b | 1352 (6.3) | 941 (8.7) | <.001b | 2390 (6.3) | 1707 (9.2) | <.001b |
| Skin rash | 99 (0.6) | 33 (0.4) | .14 | 192 (.9) | 81 (.7) | .29 | 291 (0.8) | 114 (0.6) | .077 |
| Throat symptoms | 151 (0.9) | 92 (1.2) | .14 | 442 (2.1) | 197 (1.8) | .24 | 593 (1.6) | 289 (1.5) | .92 |
| Vomiting | 406 (2.5) | 153 (2.0) | .024b | 700 (3.3) | 229 (2.1) | .001b | 1106 (2.9) | 382 (2.0) | .002b |
| Other | 7287 (45.0) | 3055 (39.3) | <.001b | 9004 (41.9) | 4584 (42.2) | .75 | 16,291 (43.2) | 7639 (41.0) | <.001b |
| Specific diagnosis, no. (%) | |||||||||
| Appendicitis | 54 (0.3) | 23 (0.3) | .81 | 65 (0.3) | 50 (0.5) | .064 | 119 (0.3) | 73 (0.4) | .26 |
| Cholecystitis | 47 (0.3) | 28 (0.4) | .59 | 51 (0.2) | 24 (0.2) | .92 | 98 (0.3) | 52 (0.3) | .92 |
| NSTEMI | 80 (0.5) | 38 (0.5) | >.99 | 92 (0.4) | 25 (0.2) | .018b | 172 (0.5) | 63 (0.3) | .090 |
| STEMI | 41 (0.3) | 10 (0.1) | .12 | 37 (0.2) | 21 (0.2) | .85 | 78 (0.2) | 21 (0.1) | .035b |
| Stroke | 183 (1.1) | 71 (0.9) | .22 | 126 (0.6) | 63 (0.6) | >.99 | 209 (0.6) | 134 (0.7) | .047b |
| Suicide | 25 (0.2) | 14 (0.2) | .85 | 39 (0.2) | 22 (0.2) | .85 | 64 (0.2) | 36 (0.2) | .73 |
| Overdose | 1 (0.0) | 1 (0.0) | >.99 | 4 (0.0) | 4 (0.0) | .65 | 5 (0.0) | 5 (0.0) | .58 |
| General diagnosis class by system, no. (%) | |||||||||
| Blood | 136 (0.8) | 61 (0.8) | .81 | 80 (0.4) | 25 (0.2) | .085 | 216 (0.6) | 86 (0.5) | .16 |
| Circulatory system | 727 (4.5) | 386 (5.0) | .18 | 599 (2.8) | 368 (3.4) | .008b | 1326 (3.5) | 754 (4.0) | .006b |
| Digestive system | 988 (6.1) | 622 (8.0) | <.001b | 1095 (5.1) | 771 (7.1) | <.001b | 2083 (5.5) | 1393 (7.5) | <.001b |
| Eyes or ears | 280 (1.7) | 90 (1.2) | .002b | 567 (2.6) | 210 (1.9) | .001b | 847 (2.2) | 300 (1.6) | .001b |
| Nervous system | 236 (1.5) | 91 (1.2) | .14 | 339 (1.6) | 140 (1.3) | .090 | 575 (1.5) | 231 (1.2) | .019b |
| Respiratory system | 1649 (10.2) | 902 (11.6) | .003b | 3687 (17.2) | 1315 (12.1) | <.001b | 5336 (14.2) | 2217 (11.9) | <.001b |
| Endocrine, nutritional, or metabolic disease | 336 (2.1) | 178 (2.3) | .44 | 348 (1.6) | 205 (1.9) | .15 | 685 (1.8) | 383 (2.1) | .11 |
| Factors influencing health status | 379 (2.3) | 189 (2.4) | .81 | 636 (3.0) | 266 (2.4) | .021b | 1016 (2.7) | 457 (2.5) | .15 |
| Genitourinary | 676 (4.2) | 456 (5.9) | <.001b | 810 (3.8) | 550 (5.1) | <.001b | 1486 (3.9) | 1006 (5.4) | <.001b |
| Infectious and parasitic disease | 341 (2.1) | 227 (2.9) | <.001b | 716 (3.3) | 315 (2.9) | .078 | 1057 (2.8) | 542 (2.9) | .62 |
| Injury, poisoning, or external cause | 1924 (11.9) | 900 (11.6) | .60 | 2788 (13.0) | 1793 (16.5) | <.001b | 4749 (12.6) | 2722 (14.6) | <.001b |
| Mental, behavioral, and neurodevelopmental | 429 (2.7) | 266 (3.4) | .003b | 670 (3.1) | 486 (4.5) | <.001b | 1104 (2.9) | 752 (4.0) | <.001b |
| Musculoskeletal system | 1093 (6.8) | 440 (5.7) | .003b | 1344 (6.3) | 735 (6.8) | .14 | 2437 (6.5) | 1175 (6.3) | .60 |
| Neoplasms | 39 (0.2) | 14 (0.2) | .59 | 16 (0.1) | 5 (0.0) | .60 | 55 (0.1) | 19 (0.1) | .32 |
| Pregnancy or childbirth | 27 (0.2) | 17 (0.2) | .60 | 95 (0.4) | 61 (0.6) | .26 | 122 (0.3) | 78 (0.4) | .15 |
| Skin and subcutaneous tissue | 416 (2.6) | 150 (1.9) | .008b | 468 (2.2) | 288 (2.7) | .021b | 884 (2.3) | 438 (2.3) | >.99 |
| Abnormal findings, not classified elsewhere | 5748 (35.5) | 2533 (32.6) | <.001b | 6588 (30.7) | 3058 (28.1) | <.001b | 12,356 (32.8) | 5596 (30.0) | <.001b |
| None | 318 (2.0) | 38 (0.5) | <.001b | 222 (1.0) | 27 (0.2) | .001b | 540 (1.4) | 65 (0.3) | <.001b |
| Pre-COVID (3/17-4/21/19) vs COVID Period (3/17-4/21/20) |
|||||||||
|---|---|---|---|---|---|---|---|---|---|
| Academic Hospitals |
Community Hospitals |
Overall |
|||||||
| 2019 (N=15,139) | 2020 (N=7779) | P | 2019 (N=19,898) | 2020 (N=10,867) | P | 2019 (N=35,037) | 2020 (N=18,646) | P | |
| Chief symptom, no. (%) | |||||||||
| Abdominal pain | 1704 (11.3) | 806 (10.4) | .077 | 1834 (9.2) | 914 (8.4) | .039b | 3538 (10.1) | 1720 (9.2) | .003b |
| Back pain | 431 (2.8) | 163 (2.1) | .001b | 550 (2.8) | 267 (2.5) | .19 | 981 (2.8) | 430 (2.3) | .002b |
| Chest pain | 1019 (6.7) | 553 (7.1) | .40 | 1287 (6.5) | 762 (7.0) | .12 | 2306 (6.6) | 1315 (7.1) | .075 |
| Other pain | 1631 (10.8) | 643 (8.3) | <.001b | 2070 (10.4) | 1099 (10.1) | .55 | 3701 (10.6) | 1742 (9.3) | <.001b |
| Cough | 412 (2.7) | 564 (7.3) | <.001b | 832 (4.2) | 637 (5.9) | <.001b | 1244 (3.6) | 1201 (6.4) | <.001b |
| Diarrhea | 136 (0.9) | 70 (0.9) | >.99 | 163 (0.8) | 91 (0.8) | .99 | 299 (0.9) | 161 (0.9) | >.99 |
| Earache or infection | 97 (0.6) | 48 (0.6) | .99 | 288 (1.4) | 126 (1.2) | .076 | 385 (1.1) | 174 (0.9) | .13 |
| Fever | 550 (3.6) | 506 (6.5) | <.001b | 695 (3.5) | 348 (3.2) | .27 | 1245 (3.6) | 854 (4.6) | <.001b |
| Gunshot wound | 3 (0.0) | 2 (0.0) | >.99 | 3 (0.0) | 1 (0.0) | >.99 | 6 (0.0) | 3 (0.0) | >.99 |
| Head injury or headache | 490 (3.2) | 181 (2.3) | <.001b | 569 (2.9) | 271 (2.5) | .11 | 1059 (3.0) | 452 (2.4) | .001b |
| Laceration | 179 (1.2) | 99 (1.3) | .73 | 436 (2.2) | 264 (2.4) | .27 | 615 (1.8) | 363 (1.9) | .19 |
| Motor vehicle accident | 123 (0.8) | 45 (0.6) | .10 | 175 (0.9) | 55 (0.5) | .002b | 298 (0.9) | 100 (0.5) | .002b |
| Shortness of breath | 862 (5.7) | 766 (9.8) | <.001b | 1219 (6.1) | 941 (8.7) | <.001b | 2081 (5.9) | 1707 (9.2) | <.001b |
| Skin rash | 124 (0.8) | 33 (0.4) | <.001b | 177 (0.9) | 81 (0.7) | .29 | 301 (0.9) | 114 (0.6) | .005b |
| Throat symptoms | 119 (0.8) | 92 (1.2) | .010b | 322 (1.6) | 197 (1.8) | .30 | 441 (1.3) | 289 (1.5) | .014b |
| Vomiting | 361 (2.4) | 153 (2.0) | .086 | 587 (3.0) | 229 (2.1) | <.001b | 948 (2.7) | 382 (2.0) | .001b |
| Other | 6898 (45.6) | 3055 (39.3) | <.001b | 8691 (43.7) | 4584 (42.2) | .020b | 15,589 (44.5) | 7639 (41.0) | <.001b |
| Specific diagnosis, no. (%) | |||||||||
| Appendicitis | 64 (0.4) | 23 (0.3) | .25 | 76 (0.4) | 50 (0.5) | .45 | 140 (0.4) | 73 (0.4) | >.99 |
| Cholecystitis | 51 (0.3) | 28 (0.4) | .97 | 43 (0.2) | 24 (0.2) | >.99 | 94 (0.3) | 52 (0.3) | .98 |
| NSTEMI | 74 (0.5) | 38 (0.5) | >.99 | 78 (0.4) | 25 (0.2) | .051 | 152 (0.4) | 63 (0.3) | .18 |
| STEMI | 21 (0.1) | 10 (0.1) | >.99 | 22 (0.1) | 21 (0.2) | .15 | 43 (0.1) | 21 (0.1) | .96 |
| Stroke | 169 (1.1) | 71 (0.9) | .25 | 121 (0.6) | 63 (0.6) | .95 | 290 (0.8) | 134 (0.7) | .27 |
| Suicide | 24 (0.2) | 14 (0.2) | .95 | 35 (0.2) | 22 (0.2) | .83 | 59 (0.2) | 36 (0.2) | .72 |
| Overdose | 5 (0.0) | 1 (0.0) | .77 | 3 (0.0) | 4 (0.0) | .53 | 8 (0.0) | 5 (0.0) | >.99 |
| General diagnosis class, no. (%) | |||||||||
| Blood | 125 (0.8) | 61 (0.8) | .93 | 76 (0.4) | 25 (0.2) | .067 | 201 (0.6) | 86 (0.5) | .16 |
| Circulatory system | 689 (4.6) | 386 (5.0) | .25 | 664 (3.3) | 368 (3.4) | .95 | 1353 (3.9) | 754 (4.0) | .41 |
| Digestive system | 941 (6.2) | 622 (8.0) | <.001b | 1122 (5.6) | 771 (7.1) | <.001b | 2063 (5.9) | 1393 (7.5) | <.001b |
| Eyes or ears | 279 (1.8) | 90 (1.2) | .001b | 520 (2.6) | 210 (1.9) | <.001b | 799 (2.3) | 300 (1.6) | <.001b |
| Nervous system | 257 (1.7) | 91 (1.2) | .005b | 352 (1.8) | 140 (1.3) | .005b | 609 (1.7) | 231 (1.2) | .002b |
| Respiratory system | 1034 (6.8) | 902 (11.6) | <.001b | 2198 (11.0) | 1315 (12.1) | .014b | 3232 (9.2) | 2217 (11.9) | <.001b |
| Endocrine, nutritional, or metabolic disease | 308 (2.0) | 178 (2.3) | .30 | 321 (1.6) | 205 (1.9) | .14 | 629 (1.8) | 383 (2.1) | .074 |
| Factors influencing health status | 393 (2.6) | 189 (2.4) | .59 | 597 (3.0) | 266 (2.4) | .014b | 990 (2.8) | 457 (2.5) | .027b |
| Genitourinary system | 677 (4.5) | 456 (5.9) | <.001b | 885 (4.4) | 550 (5.1) | .035b | 1562 (4.5) | 1006 (5.4) | <.001b |
| Infectious and parasitic disease | 227 (1.5) | 227 (2.9) | <.001b | 494 (2.5) | 315 (2.9) | .064 | 721 (2.1) | 542 (2.9) | <.001b |
| Injury, poisoning, or external cause | 1899 (12.5) | 900 (11.6) | .068 | 3059 (15.4) | 1793 (16.5) | .023b | 4958 (14.2) | 2722 (14.6) | .25 |
| Mental, behavioral, and neurodevelopmental | 386 (2.5) | 266 (3.4) | <.001b | 646 (3.2) | 486 (4.5) | <.001b | 1032 (2.9) | 752 (4.0) | <.001b |
| Musculoskeletal system | 1165 (7.7) | 440 (5.7) | <.001b | 1428 (7.2) | 735 (6.8) | .26 | 2593 (7.4) | 1175 (6.3) | <.001b |
| Neoplasms | 45 (0.3) | 14 (0.2) | .20 | 12 (0.1) | 5 (0.0) | .93 | 59 (0.2) | 19 (0.1) | .12 |
| Pregnancy or childbirth | 45 (0.3) | 17 (0.2) | .44 | 135 (0.7) | 61 (0.6) | .34 | 177 (0.5) | 78 (0.4) | .26 |
| Skin and subcutaneous tissue | 450 (3.0) | 150 (1.9) | <.001b | 499 (2.5) | 288 (2.7) | .59 | 949 (2.7) | 438 (2.3) | .029b |
| Abnormal findings, not classified elsewhere | 5640 (37.3) | 2533 (32.6) | <.001b | 6303 (31.7) | 3058 (28.1) | <.001b | 11,943 (34.1) | 5596 (30.0) | <.001b |
| None | 116 (0.8) | 38 (0.5) | .039b | 203 (1.0) | 27 (0.2) | <.001b | 369 (1.1) | 65 (0.3) | <.001b |
a
COVID = coronavirus disease; NSTEMI = non–ST-elevation myocardial infarction; STEMI = ST-elevation myocardial infarction.
b
Statistically significant.