Epidemiology and clinical features of emergency department patients with suspected COVID‐19: Results from the first month of the COVID‐19 Emergency Department Quality Improvement Project (COVED‐2)

Abstract

Objective: The aim of the present study was to describe the epidemiological and clinical features of ED patients with suspected and confirmed COVID-19. Methods: The COVID-19 Emergency Department (COVED) Project is an ongoing prospective cohort study that includes all adult patients presenting to The Alfred Hospital ED who undergo testing for SARS-CoV-2. Current guidelines recommend testing for patients with fevers or chills, acute respiratory symptoms or a high-risk exposure history, as well as implementation of infection prevention and control precautions for all suspected and confirmed cases. Study outcomes include a positive SARS-CoV-2 test result and intensive respiratory support. Results: In the period 1-30 April 2020, 702 of 3453 ED patients (20%; 95% CI 19-22) were tested, with a significant increase during the study period (incident rate ratio 1.019; 95% confidence interval 1.017-1.021, P < 0.001). The primary outcome of a positive SARS-CoV-2 test was recorded in 14 patients (2%; 95% confidence interval 1-3). Shortness of breath (77%), fatigue (100%), myalgia (67%) and diarrhoea (67%) were common among positive cases, while close contact (9%), fever (0%) and healthcare occupation (0%) were not. No positive cases required intensive respiratory support in the ED. Conclusions: The volume of ED patients with suspected COVID-19 is increasing. Low numbers of positive cases precluded development of accurate predictive tools, but the COVED Project is fulfilling an important role in monitoring the burden of infection prevention and control requirements on the ED. The

Neuromuscular presentations in patients with COVID-19

“…We identified 96 studies of COVID-19-related myalgia. After exclusion of descriptive reviews, data in other than English language, and duplicate studies, we selected 13 studies and 2 meta-analysis comprising of 10 and 55 studies, respectively (Table 1) [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Impact of patient isolation on emergency department length of stay: A retrospective cohort study using the Registry for Emergency Care

“…2 The present study was conducted during a period when there were relatively few patients testing positive for SARS-CoV-2. 1 Given the recent rise in case numbers within Victoria, the impacts of isolation may change. This will require constant monitoring in order to minimise downstream consequences, such as ED overcrowding and delayed access to definitive care.…”

“…The present study was conducted during a period when there were relatively few patients testing positive for SARS‐CoV‐2 1 . Given the recent rise in case numbers within Victoria, the impacts of isolation may change.…”

“…Although Australia has been relatively successful at containing the spread of the SARS-CoV-2 virus, a significant number of patients presenting to Australian EDs meet case definition criteria for 'suspected COVID-19'. 1,2 In response to this 'new normal', EDs have endeavoured to improve infection prevention and control (IPC) through clinical redesign, infrastructure modifications and process changes. 2,3 Isolation is an important component of IPC for patients requiring contact, droplet or airborne precautions, such as those with suspected COVID-19.…”

Epidemiology and clinical features of emergency department patients with suspected and confirmedCOVID‐19: A multisite report from theCOVID‐19 Emergency DepartmentQuality Improvement Project for July 2020 (COVED‐3)

“…The COVID‐19 pandemic continues to have a significant impact on Australian EDs 1–6 . Although the overall number of ED presentations has decreased, 5,6 substantial reforms have been required to optimise infection prevention and control (IPC) processes 7 .…”