Epidemiol Health. 2022;44:e2022044.

The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care.

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제1저자 유신혜, 심진아 · 교신저자 김범석

PMID 35538696 PMC9684015 DOI 10.4178/epih.e2022044 IF 2.4 혈액종양내과

소속 (5)

Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea.
School of AI Convergence, Hallym University, Chuncheon, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Cancer Research Institute, Seoul National University, Seoul, Korea.

Abstract

OBJECTIVES We investigated the impact of the COVID-19 pandemic on cancer care in a tertiary hospital in Korea without specific lockdown measures.

METHODS A retrospective cohort of cancer patients from one of the largest tertiary hospitals in Korea was used to compare healthcare utilization in different settings (outpatient cancer clinic, the emergency department [ED], and admissions to the hematology/oncology ward) between January 1 and December 31, 2020 and the same time period in 2019. The percent changes in healthcare utilization between the 2 periods were calculated.

RESULTS A total of 448,833 cases from the outpatient cohort, 26,781 cases from the ED cohort, and 14,513 cases from the admission cohort were reviewed for 2019 and 2020. The total number of ED visit cases significantly decreased from 2019 to 2020 by 18.04%, whereas the proportion of cancer patients remained stable. The reduction in ED visits was more prominent in patients with symptoms suspicious for COVID-19, high-acuity cases, and those who lived in non-capital city areas. There were no significant changes in the number of total visits, new cases in the outpatient clinic, or the total number of hospitalizations between the 2 periods.

CONCLUSIONS During the pandemic, the number of ED visits significantly decreased, while the use of the outpatient clinic and hospitalizations were not affected. Cancer patients' ED visits decreased after the COVID-19 outbreak, suggesting the potential for collateral damage outside the hospital if patients cannot reach the ED in a timely manner.

Keywords

COVID-19CancerCareRepublic of KoreaTertiary hospital

Figures

**Figure 1.** Number of outpatient clinic visits during the pre-COVID-19 and COVID-19 periods. (A) Total number of outpatient clinic visits. (B) Number of new cases in the outpatient clinic. COVID-19, coronavirus disease 2019.

**Figure 2.** Delay time for planned admissions during the pre-COVID-19 and COVID-19 periods. (A) Average delay time for planned admissions. (B) Percent changes of delay time for planned admissions. COVID-19, coronavirus disease 2019.

**Figure 3.** ED visits during the pre-COVID-19 and COVID-19 periods. (A) Total number of ED visits. (B) The ratio of ED visits by cancer patients to that of all patients who visited the ED. ED, emergency department; COVID-19, coronavirus disease 2019.

**Figure 4.** Percent changes in monthly ED visits stratified by various factors. (A) Percent changes of ED visits by route of visit. (B) Percent changes of ED visits by chief complaint. (C) Percent changes of ED visits by KTAS level. ED, emergency department; KTAS, Korean Triage and Acuity Scale; Sx, symptoms.

그림 출처: PubMed Central 공개 논문 (PMC9684015)

Conflict of interest statement

CONFLICT OF INTEREST . The authors have no conflicts of interest to declare for this study.

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