Yonsei Med J.  2021 Dec;62(12):1136-1144. 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

• Lee SJ
• Choi A
• Ryoo HW
• Pak YS
• Kim HC
• Kim JH

• KMID: 2522588
• DOI: http://doi.org/10.3349/ymj.2021.62.12.1136

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.

Keyword

COVID-19; emergency service; fever