Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge

Kayla E Prokopakis,1 Todd Bolotin,1,2 Chad Donley,1,2 Mark Lomasney,1 Jason Harter,1 Jack Graham,1 Quincy Chopra,1 Steven Olsen,1,2 Joseph Noga,1,2 Matthew Gatchel,2 Brendan Paull,1 Victoria Greyslak,1 Bret Bradford,1 Anna Plummer,1 Carrie Powell3 1Department of Emergency Medicine, Mercy Health St. Elizabeth Boardman Hospital, Boardman, OH, USA; 2Department of Emergency Medicine, Mercy Health St. Elizabeth Youngstown Hospital, Youngstown, OH, USA; 3Lake Erie College of Osteopathic Medicine, Erie, PA, USACorrespondence: Kayla E Prokopakis, Department of Emergency Medicine, Mercy Health St. Elizabeth Boardman Hospital, Boardman, OH, USA, Email kprokopakis32@gmail.comStudy Objective: The SARS-CoV-2 (COVID-19) pandemic significantly impacted emergency department volume and acuity. The Delta and Omicron variants contributed to additional surges. We describe the impact that the initial pandemic phase had on frequency and severity of typically non-life-threatening emergencies using upper extremity injuries as a model for other potentially emergent presentation as compared to pre-pandemic times. We do this using the epidemiology of pre-defined significant upper extremity injuries at our facility as a specific example of what occurred at an urban trauma center.Methods: We conducted a comparison of two 6-month periods: between March 2019 and August 2019 (prior to COVID-19) and between March 2020 and August 2020 after the onset of the initial COVID-19 wave. We performed a retrospective chart review of patients who presented with upper extremity injury chief complaints using analysis of the electronic medical record at a single urban tertiary care trauma center in the Midwestern United States. We investigated examination findings, imaging, frequency of surgical procedures and final diagnosis.Results: In the 2019 study period, there were 31,157 ED patients, including 429 with upper extremity injuries, of which 108 patients had significant injuries. In the 2020 study period, there were 24,295 patient presentations, of which ...