Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France

In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The...

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Veröffentlicht in:Journal francais d'ophtalmologie 2022-01, Vol.45 (1), p.1-8
Hauptverfasser: Maalej, R., Hage, R., Salviat, F., Vignal-Clermont, C.
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Hage, R.
Salviat, F.
Vignal-Clermont, C.
description In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P
doi_str_mv 10.1016/j.jfo.2021.10.002
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From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P&lt;0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures. The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown. En mars 2020, l’augmentation brutale du nombre d’infections par le SARS-CoV-2, en France, a imposé un confinement général strict ; ainsi, toutes les consultations non urgentes ont été reportées entre le 17 mars 2020 et le 10 mai 2020. Plus de 90 % des consultations en ophtalmologie ont été annulées. Le but de cette étude est d’évaluer l’impact de ce 1er confinement à Paris sur les urgences ophtalmologiques et de voir s’il y a eu des séquelles visuelles secondaires au report de consultation. Les données des patients, qui se sont présentés au service des urgences ophtalmologiques de la Fondation ophtalmologique Adolphe de Rothschild, Paris, France, ont été enregistrées pendant le confinement et un mois après. Tous les résultats ont été comparés à la même période en 2018 et en 2019. On définit ainsi 4 périodes : du 17 mars au 10 mai 2018 (P1) ; du 17 mars au 10 mai 2019 (p2) ; du 17 mars au 10 mai 2020 (LP3) ; du 11 mai au 9 juin 2020 (LP4). Le nombre des consultations aux urgences ophtalmologiques a diminué de 50 % durant le confinement (n=2909 LP3) et de 30 % au déconfinement (n=2622 LP4) comparé à P1 (n=7125) et P2 (n=8085). Même si durant le déconfinement LP4, on a eu une augmentation du nombre de consultants par jour, le pourcentage des pathologies sévères n’a pas augmenté (12,8 % LP vs 11,1 % LP4), ainsi que celui des hospitalisations (4,3 % vs 3,6 %). Les pathologies neuro-ophtalmologiques étaient les plus fréquentes durant LP3 et LP4. Le glaucome néovasculaire était 2 fois plus fréquent durant LP4 (p=0,08). On a constaté une augmentation significative des rejets de greffe de cornée durant LP4 (p&lt;0,001) secondaire au retard de consultation durant le 1er confinement. La chute brutale du nombre de patients consultant aux urgences ophtalmologiques durant le 1er confinement secondaire à l’épidémie COVID-19 a intéressé aussi bien les pathologies bénignes que sévères, sans retard diagnostique significatif. 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All rights reserved.</rights><rights>2021 Elsevier Masson SAS. All rights reserved. 2021 Elsevier Masson SAS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-29a8e0e73dffb1c9b42aa04b132a6f19542d08cf9617f07b473797277e41e17a3</citedby><cites>FETCH-LOGICAL-c408t-29a8e0e73dffb1c9b42aa04b132a6f19542d08cf9617f07b473797277e41e17a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0181551221005404$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34823891$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maalej, R.</creatorcontrib><creatorcontrib>Hage, R.</creatorcontrib><creatorcontrib>Salviat, F.</creatorcontrib><creatorcontrib>Vignal-Clermont, C.</creatorcontrib><title>Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France</title><title>Journal francais d'ophtalmologie</title><addtitle>J Fr Ophtalmol</addtitle><description>In March 2020, the sudden rise in the number of SARS-CoV-2 infections in France led the government to impose a strict lockdown during which all non-urgent medical consultations were postponed. From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P&lt;0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures. The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown. En mars 2020, l’augmentation brutale du nombre d’infections par le SARS-CoV-2, en France, a imposé un confinement général strict ; ainsi, toutes les consultations non urgentes ont été reportées entre le 17 mars 2020 et le 10 mai 2020. Plus de 90 % des consultations en ophtalmologie ont été annulées. Le but de cette étude est d’évaluer l’impact de ce 1er confinement à Paris sur les urgences ophtalmologiques et de voir s’il y a eu des séquelles visuelles secondaires au report de consultation. Les données des patients, qui se sont présentés au service des urgences ophtalmologiques de la Fondation ophtalmologique Adolphe de Rothschild, Paris, France, ont été enregistrées pendant le confinement et un mois après. Tous les résultats ont été comparés à la même période en 2018 et en 2019. On définit ainsi 4 périodes : du 17 mars au 10 mai 2018 (P1) ; du 17 mars au 10 mai 2019 (p2) ; du 17 mars au 10 mai 2020 (LP3) ; du 11 mai au 9 juin 2020 (LP4). Le nombre des consultations aux urgences ophtalmologiques a diminué de 50 % durant le confinement (n=2909 LP3) et de 30 % au déconfinement (n=2622 LP4) comparé à P1 (n=7125) et P2 (n=8085). Même si durant le déconfinement LP4, on a eu une augmentation du nombre de consultants par jour, le pourcentage des pathologies sévères n’a pas augmenté (12,8 % LP vs 11,1 % LP4), ainsi que celui des hospitalisations (4,3 % vs 3,6 %). Les pathologies neuro-ophtalmologiques étaient les plus fréquentes durant LP3 et LP4. Le glaucome néovasculaire était 2 fois plus fréquent durant LP4 (p=0,08). On a constaté une augmentation significative des rejets de greffe de cornée durant LP4 (p&lt;0,001) secondaire au retard de consultation durant le 1er confinement. La chute brutale du nombre de patients consultant aux urgences ophtalmologiques durant le 1er confinement secondaire à l’épidémie COVID-19 a intéressé aussi bien les pathologies bénignes que sévères, sans retard diagnostique significatif. 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From March 17 to May 10, 2020, private medical practices were closed, and telemedicine was encouraged. The consequences on ophthalmic care were dramatic, with over 90% of scheduled consultations canceled. The goal of this study was to describe consultations during the 2-month strict lockdown in Paris and to analyze its impact on the visual outcomes of patients consulting in the ophthalmology emergency department (OED). Data of patients who presented to the OED of the A. de Rothschild Foundation Hospital (RFH), a tertiary ophthalmology center in Paris, France, during the lockdown period and its immediate aftermath were analyzed. The results were compared to the same time periods in the years 2018 and 2019. Four time periods were defined and numbered chronologically: March 17 to May 10, 2018 (period 1); March 17 to May 10, 2019 (period 2); March 17 to May 10, 2020 (period 3, the lockdown period); May 11 to June 9, 2020 (period 4, the post-lockdown period). The number of consultations was reduced by more than 50% during the lockdown period (n=2909 patients) and by 30% during the post-lockdown period (n=2622) when compared to periods 1 (n=7125) and 2 (n=8058). Even though LP4 saw an increase in the number of patients consulting, there was no increase in the rate of severe diseases (12.8% during LP3 vs. 11.1% during LP4), and the proportion of patients who were admitted was statistically similar (4.3% vs. 3.6%). Neuro-ophthalmic diseases were the most common during LP3 and LP4. Neovascular glaucoma was twice as common during post-LP4 (P=0.08). We noted a significant increase in patients with graft rejection consulting in our OED during the post-LP4 (P&lt;0.001). These results were likely related to a delay in follow-up consultations due to the lockdown measures. The reduction in the number of consultations in our OED during the lockdown period affected both minor emergencies and severe ophthalmic diseases, but with no significant delay in diagnosis. More longitudinal and longer study is needed to confirm this and to retrospectively analyze the effects of the COVID-19 outbreak and lockdown. En mars 2020, l’augmentation brutale du nombre d’infections par le SARS-CoV-2, en France, a imposé un confinement général strict ; ainsi, toutes les consultations non urgentes ont été reportées entre le 17 mars 2020 et le 10 mai 2020. Plus de 90 % des consultations en ophtalmologie ont été annulées. Le but de cette étude est d’évaluer l’impact de ce 1er confinement à Paris sur les urgences ophtalmologiques et de voir s’il y a eu des séquelles visuelles secondaires au report de consultation. Les données des patients, qui se sont présentés au service des urgences ophtalmologiques de la Fondation ophtalmologique Adolphe de Rothschild, Paris, France, ont été enregistrées pendant le confinement et un mois après. Tous les résultats ont été comparés à la même période en 2018 et en 2019. On définit ainsi 4 périodes : du 17 mars au 10 mai 2018 (P1) ; du 17 mars au 10 mai 2019 (p2) ; du 17 mars au 10 mai 2020 (LP3) ; du 11 mai au 9 juin 2020 (LP4). Le nombre des consultations aux urgences ophtalmologiques a diminué de 50 % durant le confinement (n=2909 LP3) et de 30 % au déconfinement (n=2622 LP4) comparé à P1 (n=7125) et P2 (n=8085). Même si durant le déconfinement LP4, on a eu une augmentation du nombre de consultants par jour, le pourcentage des pathologies sévères n’a pas augmenté (12,8 % LP vs 11,1 % LP4), ainsi que celui des hospitalisations (4,3 % vs 3,6 %). Les pathologies neuro-ophtalmologiques étaient les plus fréquentes durant LP3 et LP4. Le glaucome néovasculaire était 2 fois plus fréquent durant LP4 (p=0,08). On a constaté une augmentation significative des rejets de greffe de cornée durant LP4 (p&lt;0,001) secondaire au retard de consultation durant le 1er confinement. La chute brutale du nombre de patients consultant aux urgences ophtalmologiques durant le 1er confinement secondaire à l’épidémie COVID-19 a intéressé aussi bien les pathologies bénignes que sévères, sans retard diagnostique significatif. Des études longitudinales et avec plus de recul sont nécessaires pour analyser rétrospectivement l’effet du confinement secondaire, l’épidémie COVD-19, sur les pathologies ophtalmologiques.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>34823891</pmid><doi>10.1016/j.jfo.2021.10.002</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals; Alma/SFX Local Collection
subjects Communicable Disease Control
Confinement
COVID-19
COVID-19 pandemic
Disease Outbreaks
Emergencies
Eye
Humans
Lockdown
Ophthalmic Emergency Department
Ophthalmology
Original
Pandémie COVID-19
Referral and Consultation
Retrospective Studies
SARS-CoV-2
Service des urgences ophtalmologiques
title Impact of lockdown during the COVID-19 outbreak on ophthalmological emergencies in a referral center in France
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