Impact of the early phase of the COVID-19 pandemic on emergency department-to-intensive care unit admissions in...

Area of Science:

• Critical Care Medicine
• Epidemiology
• Public Health

Background:

• The COVID-19 pandemic caused global critical care system disruptions.
• Limited research exists on the pandemic's impact on emergency department (ED) to intensive care unit (ICU) admissions.
• This study addresses the gap by evaluating changes in ED-to-ICU admissions and outcomes.

Purpose of the Study:

• To evaluate changes in the number of ED-to-ICU admissions before and during the COVID-19 pandemic.
• To assess the impact of the pandemic on in-hospital mortality rates for ED-to-ICU patients.
• To identify specific patient groups or factors affected by the pandemic's influence on critical care.

Main Methods:

• Utilized interrupted time-series analysis to examine monthly trends.
• Included adult patients admitted to the ICU via EDs in Korea from February 2018 to January 2021.
• Defined February 2020 as the pandemic onset point.

Main Results:

• A significant decrease in the number of ED-to-ICU admissions was observed during the pandemic.
• The proportion of patients arriving via emergency medical services, transferred from other hospitals, or with injuries declined.
• In-hospital mortality rates significantly increased during the pandemic, especially for patients with prolonged ED stays (≥6 hours).

Conclusions:

• The COVID-19 pandemic significantly altered ED-to-ICU admission patterns and increased in-hospital mortality in Korea.
• Findings highlight the need for healthcare strategies to manage future infectious disease outbreaks.
• Improved management protocols are crucial for critically ill patients during pandemics.