Impact of COVID-19 related lockdown on hospital admissions, hospital burden and deaths due to non- COVID illnesses in a tertiary care centre in Southern Sri Lanka

Background: Sri Lanka imposed an aggressive curfew to prevent the spread of COVID-19, which led to major changes in population behaviour. It was presumed that these measures could affect the morbidity patterns and management of other medical conditions. We aimed to study the impact of the pandemic on hospital admissions, morbidity patterns and mortality from non-COVID illnesses during the period of lockdown.

Methods: A retrospective study was conducted to gather data related to all non- COVID medical admissions from four medical wards and emergency treatment unit (ETU) of the Teaching Hospital Karapitiya for a six-week period during the lockdown. Data on the total number of admissions, reasons for admission, diagnoses, duration of hospital stay and outcome including deaths were obtained. Corresponding data from the same period of the previous year (pre COVID period) were compared.

Results: The total number of admissions during the pre- COVID period was 2939 and that reduced to 1491 during the lockdown period. There was a significant reduction of admissions due to infectious illnesses including respiratory tract infections (p <0.001), dengue (p= 0.01) and leptospirosis (p=0.02) during the lockdown period. There was a significant increase in requested admissions (p=0.002) including admissions for procedures, investigations, referrals and transfers. The mortality during the two periods did not change significantly (pre-covid period 5.1 %, lockdown period 4.2%, p=0.16).

Conclusions: The results of the study showed that social distancing and travel restriction had a significant impact on health seeking behaviour, disease patterns and outcome. Reduction in hospital admissions and changes in disease patterns, especially reduction in respiratory tract infections could be a positive effect of preventive measures: physical distancing, wearing masks and travel restriction. Total lockdown of the country had no significant effect on total deaths as well as deaths related to NCDs.