J Korean Soc Emerg Med.  2022 Feb;33(1):84-93.

The impact of the COVID-19 pandemic on emergency department length of stay and outcomes of pneumonia patients

• Ha JS
• Seo SW
• Lee JY
• Lee WS
• Sung WY
• Lee KT

Abstract

Objective
This study aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) outbreak on the emergency department length of stay (ED-LOS) and outcomes of patients admitted with pneumonia.
Methods
This was a retrospective observational study that included adult pneumonia patients admitted to the emergency department during the period from February to July 2019 and the corresponding period in 2020. After the COVID-19 outbreak, many changes occurred in medical systems, causing prolonged ED-LOS. We divided ED-LOS into pre-, mid-, and post-ED-LOS and compared ED-LOS, hospital LOS and in-hospital mortality rates of pneumonia patients during the above-mentioned periods. In addition, a multivariable logistic regression analysis was performed to identify the risk factors leading to in-hospital mortality in 2020.
Results
A total of 365 patients were included in the study. Pre-ED-LOS, mid-ED-LOS, post-ED-LOS, and in-hospital mortality in the 2020 group were significantly higher than those of the 2019 group (P<0.05). Mid-ED-LOS (odds ratio [OR], 1.474; P=0.001) and post-ED-LOS (OR, 1.098; P=0.024) were identified as being independently associated with an increased risk of in-hospital mortality in 2020.
Conclusion
Our study shows that ED-LOS and in-hospital mortality increased after the COVID-19 pandemic. Mid-ED-LOS and post-ED-LOS were independently associated with an increased risk of in-hospital mortality in patients with pneumonia in 2020.

Keyword

COVID-19; Pneumonia; Emergency department; Length of stay; Mortality