ArticleCureus2026
Epidemiology of Emergency Department Visits Before, During, and After the COVID-19 Pandemic: Experience From a Referral Center in Southeastern Brazil.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
Background The COVID-19 pandemic and its related restrictions were associated with changes in emergency department (ED) utilization, with reductions reported in many regions worldwide. In Brazil, where EDs often serve non-urgent cases, the long-term impact remains unclear. Therefore, this study evaluated ED utilization trends across pre-pandemic, pandemic, and post-pandemic periods in a large tertiary hospital. Methods This retrospective observational study analyzed all ED visits recorded at the University of Campinas Clinics Hospital, a tertiary care referral hospital in southeastern Brazil, from January 2018 to December 2024. Data from the electronic medical record system were categorized into pre-pandemic, pandemic, and post-pandemic periods. Temporal trends in total, adult, and pediatric ED visits, as well as by medical specialty, were evaluated using joinpoint regression (Joinpoint Regression Program, version 4.9.0.1). Results Between Jan/18-Feb/20 (pre-pandemic), Mar/20-May/23 (pandemic), and Jun/23-Dec/24 (post-pandemic), 388,733 ED visits were recorded, including 329,111 adults and 59,622 pediatrics. Total visits declined by 39.5% from 2019 (69,519 visits) to 2020 (41,991), with reductions of 34.8% among adults (56,813 to 37,013) and 60.8% among children (12,706 to 4,978). Joinpoint analysis for total visits identified a sharp negative trend at the onset of the pandemic (p = 0.03), followed by a gradual recovery that did not reach pre-pandemic levels by 2024 (77.8% of baseline; pre-pandemic mean = 70,701; visits in 2024 = 54,987). Temporal patterns varied by specialty: neurology and some surgical specialties showed growth, while internal medicine, psychiatry, and ophthalmology exhibited distinct fluctuations and incomplete recovery. Conclusion The COVID-19 pandemic caused a marked and prolonged disruption in ED services utilization. Although visit volumes gradually recovered, they remained below pre-pandemic levels, with variable patterns across age groups and specialties. These findings highlight lasting shifts in healthcare-seeking behavior and the need for adaptive planning for future health crises.
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