J Korean Med Sci.  2024 Jun;39(23):e187. 10.3346/jkms.2024.39.e187.

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

• Lee KS
• Sung HK
• Choi YY
• Han C
• Min HS

• KMID: 2556681
• DOI: http://doi.org/10.3346/jkms.2024.39.e187

Abstract

Background
We performed a nationwide analysis to evaluate the impact of the early coronavirus disease 2019 (COVID-19) pandemic on emergency department (ED) visits by adult cancer patients having COVID-like symptoms.
Methods
We analyzed the National Emergency Department Information System (NEDIS) data on ED visits by adult cancer patients who presented with chief complaints of fever or respiratory symptoms (FRS) indicative of COVID-19, from 2016 to 2020. An interrupted time series analysis with a quasi-Poisson regression model was performed, adjusting for seasonality and time, to evaluate whether underlying trends for monthly ED visits and the in-hospital mortality rate (%) per month changed with the pandemic among these patients. We also estimated the adjusted odds ratio (aOR) of in-hospital deaths among cancer patients using multivariable logistic regression analysis.
Results
ED visits by cancer patients with FRS decreased during the COVID-19 pandemic (relative risk [RR] with 95% confidence interval [CI]: slope change, 0.99 [0.98–1.00] and step change, 0.84 [0.76–0.92]). However, the in-hospital mortality rate (%) for these patients was increased (slope change, 1.14 [1.04–1.25] and step change, 0.99 [0.98–1.01]). Factors such as urgent triage status, ambulance use, and treatment in hospitals with fewer than 300 staffed beds significantly contributed to increased aOR of in-hospital deaths during the COVID-19 pandemic compared to the pre-pandemic period.
Conclusion
Further studies are needed to highlight the importance of ED service preparation in planning and managing resources for cancer patients during future pandemics.

Keyword

Cancer; COVID-19 Pandemic; Interrupted Time Series; Mortality; NEDIS

Figure

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  Fig. 1 Flowchart for selection of study population.ED = emergency department.

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  Fig. 2 The association between the coronavirus disease 2019 pandemic (February 2020-) and changes in cancer-related ED visits and in-hospital mortality (%) per month among those patients of Korea.ED = emergency department.*P < 0.05.

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