Toxicology presentations to a tertiary unit in New South Wales during the COVID‐19 pandemic first wave: A retrospective comparison study

Abstract

Objective To compare presentation numbers, class of exposure, poison severity score (PSS) and drugs ingested by patients in a tertiary toxicology service during the first wave of the COVID‐19 pandemic to the corresponding time periods in 2018 and 2019. Methods A retrospective cohort observational study of patients admitted or consulted to the Western Sydney Toxicology Service (WSTS) from ED during February to May in 2018–2020. Patient age, sex, triage category, time and date of arrival, mode of arrival, type of poisoning, discharge location, length of stay and PSS were collected from WSTS database and electronic medical records. The total number of ED presentations, hospital admissions and toxicology admissions were gathered from hospital‐based data services. Results There was an overall increase in toxicology presentations in February to May 2020 ( n = 441) compared to 2019 ( n = 333) and 2018 ( n = 255). The daily rate of presentations increased in March to May 2020 with an overall rate ratio of 1.42, 95% confidence interval 1.23–1.63, P < 0.001. There was an increase in presentations across all drug types. From March to April 2020, there was significantly higher number of daily presentations for recreational drugs use compared to 2018. Conclusion There was a relative increase in toxicology presentations during the COVID‐19 pandemic compared to an overall decrease in presentations to ED. Recreational drug use increased significantly during the pandemic compared to 2018.

The impact of theCOVID‐19 pandemic on emergency department presentations: an opportunity for renewal?

“…They found substantial reductions in the numbers of presentations during the most stringent COVID‐19 restrictions (11 March 2020 – 30 June 2020), except by people with stroke‐like conditions 3 . Other Australian studies have reported increased numbers of ED presentations by people with certain conditions, including presentations to New South Wales emergency departments with self‐harm or suicidal ideation by young people, particularly adolescent girls, 4 and a relative increase in the number of presentations to a tertiary toxicology service in western Sydney despite an overall reduction in ED presentations 5 …”