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Regional Trends of COVID-19-Like Illness-Related Emergency Department Visits in North Carolina, March 1,

Gregory D Kearney1, Ray Hylock2, Yoo Min Park3

  • 1DrPH Environmental and Occupational Health Program, Department of Public Health, Brody School of Medicine, East Carolina University.

North Carolina Medical Journal
|January 7, 2026
PubMed

Insights

COVID-19-like illness emergency department visits in North Carolina peaked in July and November 2020. The Piedmont region saw the most visits, with younger adults and White individuals most affected, though disparities were noted in the Eastern region.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Limited data exists on emergency department (ED) visits for COVID-19-like illness (CLI) during the early SARS-CoV-2 (COVID-19) pandemic in North Carolina.
  • Understanding these initial trends is crucial for public health response and resource allocation.

Purpose of the Study:

  • To characterize emergency department visits related to COVID-19-like illness (CLI) across North Carolina.
  • To analyze regional trends in CLI-related ED visits from March to November 2020.

Main Methods:

  • Retrospective, descriptive study utilizing data from NC DETECT and US Census Bureau.
  • Calculated CLI-related ED visit rates for North Carolina residents.
  • Compared and described regional trends (Eastern, Piedmont, Western).

Main Results:

  • 133,193 CLI-related ED visits were analyzed.
  • Visit trends peaked in mid-July and late November 2020 across all regions.
  • The Piedmont region had the highest percentage of visits (56.3%).
  • Individuals aged 25-49 years comprised the largest demographic group (35.0%).
  • White individuals accounted for the majority of visits (47.8%), but the Eastern region showed a disproportionately higher percentage of visits for Black and American Indian individuals (44.8%).

Conclusions:

  • The study provides a comprehensive overview of regional CLI-related ED visit trends during the initial nine months of the COVID-19 pandemic in North Carolina.
  • Limitations included the unavailability of specific ICD-10-CM codes in the early pandemic weeks.
  • Findings offer valuable insights for public health officials, healthcare administrators, and policymakers to inform future pandemic preparedness and response strategies.
Abstract

Keywords:
Gregory D. Kearneycovidemergency departmenthealth carehealth policyillnesslong covidnorth carolinaregional trendsresearch

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