The Lombardy Emergency Medical System Faced with COVID-19: The Impact of Out-of-Hospital Outbreak

Figures & data

Figure 1. Number of events managed by the EMS in March and April 2019 and 2020. Panel A reports the number of events managed by the dispatch center, the number of “Breathing” or “Infective” events and the number of patients transported to hospital. Panel B reports the number of patients not transported to hospital and the number of patients died. *: p < 0.0001; #: p = 0.054.

Table 1. Waiting time for ambulance in hospital

	2019		2020
	March	April	March	April
Brescia	10 (2)	10 (1)	17 (3)*^#	15 (2)*^#
Bergamo	15 (2)	15 (2)	32 (28)*^#	17 (3)
Bergamo and Brescia	12 (6)	11 (4)	22 (16)*^#	16 (4)*^#

Ambulance median waiting time (IQR) before patient admission into the emergency department. Data refer to both areas (first two rows), and to the data pooled together (last row). Data are presented as median (IQR). Statistical analysis was performed by means of Kruskal Wallis test for non-parametric data. *: p < 0.05 compared to March 2019; ^#: p < 0.05 compared to April 2019.

Table 2. Severity at admission into emergency department

	March and April 2019	March and April 2020	OR [IC95%]	p
RED CODE	359	624	1.4 [1.2–1.5]	<0.0001
YELLOW CODE	4,245	9,297	2.1 [2.0–2.2]	<0.0001
GREEN CODE	16,657	14,751	0.27 [0.26–0.28]	<0.0001
WHITE CODE	58	166	2.2 [1.7–4.9]	<0.0001
Total	20,128	26,029

Number of events in the hospitals of the two considered areas grouped by color code, data for Brescia and Bergamo pooled together. See Supplementary Material, Tables S1 and S2, for the data divided by single hospital and single province. The table reported the odds ratio; χ² test was performed to set differences.

Table 3. Characteristics of the patients

	2019	2020	p
Patients, n	3,017	19,247
Age (y)
median [IQR]	78 [56–86]	70 [56–80]	<0.0001
Sex, n				OR [IC95%]
Male	1,347	10,392	<0.0001	1.5 [1.1–1.6]
Female	1,587	6,747	<0.0001	0.49 [0.45–0.53]
Missing data	83	2,108
SpO2 (%) median [IQR]
Ambient air	96 [92.25–98]	94 [88–97]	<0.0001
n	1836	10844
Oxygen	96 [93–98]	94 [90–97]	<0.0001
n	1047	6648
ΔSpO2	7 [5–11]	10 [7–15]	<0.0001
n	416	3243

Characteristics of the patients between 2019 and 2020. The categorical variable was tested by means of χ² test. Mann-Whitney test was applied for continuous variables. ΔSpO₂: difference between SpO₂ during oxygen administration and SpO2 in air.