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. 2021 Dec;62(12):1136-1144.
doi: 10.3349/ymj.2021.62.12.1136.

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

Seung Joon Lee  1 , Arom Choi  2 , Hyun Wook Ryoo  3 , Yun-Suk Pak  1 , Hyeon Chang Kim  4 , Ji Hoon Kim  2   5
Affiliations

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

Seung Joon Lee et al. Yonsei Med J. 2021 Dec.

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.

Keywords: COVID-19; emergency service; fever.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Flowchart of the patient enrollment process. ED, emergency department; DOA, death on arrival.
Fig. 2
Fig. 2. Change in the proportion of enrolled patients with a focus on fever during the coronavirus disease (COVID-19) outbreak.
Fig. 3
Fig. 3. Subgroup analysis of admission rates. KTAS, Korean triage and acuity scale; ED, emergency department.
Fig. 4
Fig. 4. Subgroup analysis on ED LOS. KTAS, Korean triage and acuity scale; ED, emergency department; LOS, length of stay.
See this image and copyright information in PMC

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