Investigating the trend of Prehospital Emergency Missions in Mashhad before and after COVID-19

Document Type : Research Paper


1 MSc, Department of Biostatistics, Social Determinants of Health Research center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

2 MSc, Prehospital emergency department statistics expert, Department of Emergency medical services, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Assistant Professor, Torbat Heidariyeh University of Medical Sciences, Torbat Heidariyeh, Iran.

4 Head of Prehospital Emergency medical services, Department of Emergency medical services, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Technical and Operations Deputy of Prehospital Emergency medical services, Department of Emergency medical services, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Research interface of the Department of Emergency medical services, Department of Emergency medical services, Mashhad University of Medical Sciences, Mashhad, Iran.


The main purpose of this study is to compare the number of emergency missions (cardiac, respiratory, poisoning, traffic accidents, types of traumas, etc.), the number of calls and operating times of the prehospital emergency in Mashhad before and after covid-19. Also our policies in epidemics future incidents are determined based on it, and we can have better planning in case of similar crises.
Methods: This study is descriptive and retrospective. Information divided into two periods: before Covid-19 from February 2018 to January 2020 and after Covid-19 from February 2020 to January 2022 . Chi-square test was used to compare the mean of the classified data, and logistic regression was used to calculate the odds-ratio the disease in emergency missions in two groups.
Results: The results showed that after the epidemic, 56.4% of these were men, and 43.6% were women, and the mean age was 45.20 ± 21.5. The missions after the epidemic showed that the mean age of the patients was 30.5 ± 16.3. The number of missions related to respiratory problems increased by 40% and fever and infectious diseases by 32% after the epidemic. The odds ratio of mission with patients with symptoms and respiratory problems before covid-19 (OR=1.43 CI=1.41-1.45, p =0.000) was 1.43 times compared after covid-19.
Conclusion: During the Covid-19 epidemic the number of missions and emergency calls increased. The prehospital emergency department increased its operational capacity by changing its plans and approaches by increasing its response capacity and the number of staff and related training.


  1. World Health Organization. Coronavirus disease 2019 (COVID-19) dashboard. 2020. Available at: Accessed August 13.
  2. Hartley DM, Perencevich EN. Public health interventions for COVID-19: emerging evidence and implications for an evolving public health crisis. Jama. 2020;323(19):1908-9.
  3. Saberian P, Conovaloff JL, Vahidi E, Hasani-Sharamin P, Kolivand P-H. How the COVID-19 Epidemic Affected Prehospital Emergency Medical Services in Tehran, Iran. West J Emerg Med. 2020;21(6):110-6.
  4. Niu S, Tian S, Lou J, Kang X, Zhang L, Lian H, et al. Clinical characteristics of older patients infected with COVID-19: A descriptive study. Archives of gerontology and geriatrics. 2020;89:104058.
  5. Maudet L, Sarasin F, Dami F, Carron P-N, Pasquier M. Emergency medical services: COVID-19 crisis. Revue medicale suisse. 2020;16(691-2):810-4.
  6. Penverne Y, Jenvrin J, Montassier E. EMS dispatch center activity during the COVID-19 containment. The American Journal of Emergency Medicine. 2020.
  7. Al Amiry A, Maguire BJ. Emergency Medical Services (EMS) Calls During COVID-19: Early Lessons Learned for Systems Planning (A Narrative Review). Open Access Emergency Medicine: OAEM. 2021;13:407.
  8. Jeffery MM, D’Onofrio G, Paek H, Platts-Mills TF, Soares WE, Hoppe JA, et al. Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US. JAMA internal medicine. 2020;180(10):1328-33.
  9. Gershon RRM, Vandelinde N, Magda LA, Pearson JM, Werner A, Prezant D. Evaluation of a Pandemic Preparedness Training Intervention for Emergency Medical Services Personnel. Prehospital and Disaster Medicine. 2012;24(6):508-11.
  10. O'Connor AW, Hannah HA, Burnor EA, Fukutaki KG, Peterson T, Ballard DW, et al. Emergency Medical Service Utilization and Response Following COVID-19 Emergency and Stay-at-Home Policies: An Interrupted Time-Series Analysis. Cureus. 2021;13.
  11. Al-Wathinani A, Hertelendy AJ, Alhurishi S, Mobrad A, Alhazmi R, Altuwaijri M, et al. Increased Emergency Calls during the COVID-19 Pandemic in Saudi Arabia: A National Retrospective Study. Healthcare. 2021;9(1):14.
  12. Yang BY, Barnard LM, Emert JM, Drucker C, Schwarcz L, Counts CR, et al. Clinical Characteristics of Patients With Coronavirus Disease 2019 (COVID-19) Receiving Emergency Medical Services in King County, Washington. JAMA Network Open. 2020;3(7):e2014549-e.
  13. Attari J, Dijk MPV. Reaching the poor in Mashhad City: from subsidising water to providing cash transfers in Iran. International Journal of Water. 2016;10(2-3):213-27.
  14. Laukkanen L, Lahtinen S, Liisanantti J, Kaakinen T, Ehrola A, Raatiniemi L. Early impact of the COVID-19 pandemic and social restrictions on ambulance missions. European Journal of Public Health. 2021;31(5):1090-5.
  15. Goldberg SA, Cash RE, Peters G, Weiner SG, Greenough PG, Seethala R. The impact of COVID‐19 on statewide EMS use for cardiac emergencies and stroke in Massachusetts. Journal of the American College of Emergency Physicians Open. 2021;2(1):e12351.
  16. Giannouchos TV, Biskupiak J, Moss MJ, Brixner D, Andreyeva E, Ukert B. Trends in outpatient emergency department visits during the COVID-19 pandemic at a large, urban, academic hospital system. The American journal of emergency medicine. 2021;40:20-6.
  17. Stella F, Alexopoulos C, Scquizzato T, Zorzi A. Impact of the COVID-19 outbreak on emergency medical system missions and emergency department visits in the Venice area. European Journal of Emergency Medicine. 2020;27
  18. Hartnett KP, Kite-Powell A, DeVies J, Coletta MA, Boehmer TK, Adjemian J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits - United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704.
  19. Siman-Tov M, Strugo R, Podolsky T, Blushtein O. An assessment of treatment, transport, and refusal incidence in a National EMS's routine work during COVID-19. The American Journal of Emergency Medicine. 2021;44:45-9.
  20. Yasin YJ, Grivna M, Abu-Zidan FM. Global impact of COVID-19 pandemic on road traffic collisions. World Journal of Emergency Surgery. 2021;16(1):51.
  21. Eskol JR, Zegers FD, Wittrock D, Lassen AT, Mikkelsen S. Increased ambulance on-scene times but unaffected response times during the first wave of the COVID-19 pandemic in Southern Denmark. BMC Emergency Medicine. 2022;22(1):61.