Changes in The Use of After-Hour House-Call Medical Services For Fever or Common Cold Symptoms During The COVID-19 Pandemic in Tokyo, Japan: A Descriptive Study

Background: The trend in the characteristics of patients using an after-hour house-call (AHHC) medical service changed the coronavirus disease of 2019 (COVID-19) pandemic, but there has been no report on this issue since the start of the COVID-19 pandemic. The aim of this study was to investigate patients’ tendencies to seek an AHHC medical service for fever or common cold symptoms during the COVID-19 pandemic. Methods: This cohort study compared the characteristics of patients with fever or symptoms of the common cold utilizing an AHHC medical service offered by a single large company between the control period (December 1, 2018 to April 30, 2019) and the COVID-19 pandemic exposure period (December 1, 2019 to April 30, 2020). It also assessed the proportion of these patients in relation to all patients calling for the service for any reason. Results: During the control and COVID-19 pandemic exposure periods, 6,462 (median age: 8 [interquartile range {IQR}: 3, 11], males: 48.2%) and 10,003 (median age: 10 [IQR: 4, 33], males: 48.3%) patients, respectively, called for the AHHC medical service. Of these, 5,335 (82.6%) and 7,423 (74.2%) patients had fever or common cold symptoms, respectively. The disease severity was differently distributed between the groups: the proportions of people with severe, moderate, and mild illness were 0.3%, 28.7%, and 71.0% in the control period and 1.1%, 54.8%, and 44.1% in the COVID-19 pandemic exposure period (p < 0.001), respectively. The AHHC medical service identified six individuals with COVID-19. Conclusions: During the COVID-19 pandemic, the proportion of patients with fever or symptoms of the common cold was lower than that in the control period, but the illness severity was substantially higher.