Changes in Clinical Characteristics among Febrile Patients Visiting the Emergency Department before and after the COVID-19 Outbreak

Abstract

Purpose Considering the risk of coronavirus disease (COVID-19) transmission through infected droplets, emergency department (ED) operations in response to febrile patients should be planned. We investigated the general and clinical characteristics of febrile patients visiting the ED and changes in admission rates via the ED during the COVID-19 outbreak. Materials and Methods We performed a retrospective analysis of prospectively collected patients who visited 402 EDs in the Republic of Korea with febrile symptoms between January 27 and May 31, 2020 and compared them to those enrolled before the COVID-19 outbreak. The primary outcome was admission rate; the secondary outcome was length of stay (LOS) in the ED. Results In total, 266519 patients had febrile symptoms at ED presentation after the COVID-19 outbreak. In 2019, before the outbreak, there were 437762 patients. The rate of ED visits among pediatric patients (aged <15 years) decreased to 21.4% after the COVID-19 outbreak, compared with 41.8% in 2019. The proportion of patients admitted after ED management was higher after the outbreak (31.3%) than before (25.2%). The adjusted odds ratio for admission was 1.04 (95% confidence interval: 1.02–1.05) after the outbreak. Compared to before the COVID-19 outbreak, the median ED LOS increased by 16 min after the outbreak. Conclusion This study confirmed that admission rates and ED LOS increased for febrile patients visiting the ED after the COVID-19 outbreak. This could provide evidence for developing ED-related strategies in response to the ongoing COVID-19 outbreak and other infectious disease pandemics.

Impact of the Early COVID-19 Pandemic on Emergency Department Visits of Adult Cancer Patients With Fever or Respiratory Symptoms: A Korean Nationwide Population-Based Study, 2016–2020

“…Furthermore, our findings showed a significant increase in the average EDLOS during the COVID-19 pandemic compared to the pre-pandemic period among cancer patients with FRS. This change is in line with previous research and can be attributed to several factorsm, 27 28 including an increase in the severity of illness among these patients, ED overcrowding due to reduced availability of ICU beds for non-COVID-19 patients, and the increased time required to implement infection prevention measures in the ED. 21 …”

The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care

“…Third, the actual incidence of respiratory infectious diseases in cancer patients may have been reduced because of a high level of social distancing and behavioral changes (e.g., maintaining good personal hygiene such as wearing a mask and regularly washing one’s hands). This hypothesis is supported by a Korean national retrospective study showing that a reduction in the diagnosis of respiratory infectious diseases was observed among febrile patients who visited the ED in 2020 compared with 2019 [ 37 ].…”

Advantage of Vital Sign Monitoring Using a Wireless Wearable Device for Predicting Septic Shock in Febrile Patients in the Emergency Department: A Machine Learning-Based Analysis

“…Patients who visit the emergency department (ED) for fever account for 5% of all patients and 15% of all older adult patients in the ED, and those with chronic diseases or aged ≥65 years have a 30-day mortality rate of 7-9% [1]. Sepsis is a serious complication in patients who present to the ED with febrile symptoms and can lead to a fatal clinical outcome [2].…”