This is a summary, written by members of the CITF Secretariat, of:
Rosychuk RJ, Khangura JK, Ortiz SS, Cheng I, Bielska IA, Yan J, Morrison LJ, Hayward J, Grant L, Hohl CM; Canadian COVID-19 Rapid Response Network (CCEDRRN) for the Network of Canadian Emergency Researchers (NCER). Characteristics and outcomes of patients with COVID-19 who return to the emergency department: a multicentre observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). Emerg Med J. 2024 Feb 16:emermed-2023-213277. doi: 10.1136/emermed-2023-213277.
The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.
A CITF-funded study, published in Emergency Medicine Journal, using data from 47 Canadian Emergency Departments (ED), found that between March 1, 2020 and March 31, 2022, one in 10 patients had an unscheduled ED return visit for COVID-19 within 30 days and the median time to return was four days. Older age, pregnancy, presence of co-morbidities (e.g. cancer, obesity, organ transplant), current/prior substance use, higher temperature, or WHO severe disease were associated with a higher likelihood of ED returns. Return was less likely for females and those who were boosted or fully vaccinated. The study was led by Dr. Rhonda Rosychuk (University of Alberta) and Dr. Corinne Hohl (University of British Columbia) on behalf of the Canadian COVID-19 Rapid Response Network (CCEDRRN) for the Network of Canadian Emergency Researchers (NCER).
Between March 1, 2020 and March 31, 2022, there were 39,809 patients diagnosed with COVID-19 in EDs across Canada. They accounted for 44,862 COVID-19-related ED visits during six pandemic waves at 47 sites (mean=1.1 visits per patient).
Key findings:
- 35,468 patients (89%) had one visit while 4,341 (11%) returned to the ED within 30 days (mean 2.2 visits).
- Return was less likely for females (OR=0.82), and those boosted or fully vaccinated (OR=0.48).
- 40% of single visit (SV) patients and 16% of multiple visit (MV) patients were admitted at their first visit. 41% of MV patients not admitted at their first ED visit were admitted on their second visit. In the MV group, the median time to return between the first and the second visit was four days, and 49% returned within 72 hours.
- The median length of hospital stays for admitted patients in the MV group was 10 days. Most of the deaths in the MV group occurred at the second ED visit (185/208), with nine occurring in the ED on the second visit.
- Repeat visits were associated with a variety of factors, including older age (Odds Ratio=1.25 per 10 years), pregnancy (OR=1.86), presence of comorbidities (e.g., OR= 1.72 for cancer, OR=2.01 for obesity, OR=2.18 for organ transplant), current/prior substance use (OR=1.52), higher temperature (OR=1.34 per degree Celsius), or WHO severe diseaseIncludes respiratory distress and arrival respiratory rate (OR=1.41).