Proportion of Emergency Department Visits for Alcohol Abuse Increased After the Arrival of COVID-19
Abstract
Objectives: The goal of our study was to determine whether there was a change in the proportion of ED visits for alcohol abuse following the arrival of COVID-19.
Background: In March of 2020, COVID-19 arrived in the New York Metropolitan area. Total ED visits decreased markedly, likely because of fear of exposure to the virus as well as social isolation mandates. Concerns have been raised regarding the possible adverse effects that COVID-19 may have on increased abuse of alcohol. COVID-19 triggered bouts of anxiety, isolation from peers, and increased family tensions because of job disruptions and quarantining within families. A CDC study showed that despite decreased total ED visits, compared to 2019, the proportion of ED mental health related visits in 2020 increased. The goal of our study was to determine whether there was a change in the proportion of ED visits for alcohol abuse following the arrival of COVID-19.
Methods: Design: Retrospective cohort. Setting: EDs of 27 hospitals within 150 miles of New York City. Hospitals were teaching and non-teaching in rural, suburban, and urban areas. Total annual ED volumes ranged from 12,000 to 122,000. Population: Consecutive patients seen by ED physicians. The database contained visits between March 1 and November 30 in 2019 and 2020. Data analysis: We identified patients with alcohol abuse using International Classification of Disease codes, version 10 (ICD-10). We tallied the number of ED visits for ICD-10 codes with at least 100 visits in the database. We calculated the proportion of these visits to total ED visits in 2019 and 2020. We report the relative change in this proportion from 2019 to 2020, along with the 95% CI.
Results: The database contained 1,161,080 visits in 2019 and 814,252 in 2020. Of these, 15,057 and 12,467 patients had a diagnosis of alcohol abuse in 2019 and 2020, respectively. For patients with alcohol abuse diagnoses in 2019 and 2020 the average ages were 46 and 47 years and females comprised 25% and 23%, respectively. The relative change in the proportion of visits for alcohol abuse from 2019 to 2020 had a statistically significant increase of 18% (95% CI: 15%-21%).
Conclusion: The proportion of ED visits for alcohol abuse increased following the arrival of COVID-19 in the New York metropolitan area. Our results are consistent with the CDC study showing the proportion of ED mental health related visits increased.