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Emergency Department Crowding is Harder to Solve: The Impact of COVID-19 of Longer Length of Stay


 Objectives

To determine the impact of the Coronavirus disease-2019 (COVID-19) pandemic on the length of stay (LOS) and prognosis of patients in the emergency department (ED).
Methods

 A retrospective review of case data of patients in the ED during the early stages of the COVID-19 pandemic in the First Affiliated Hospital of Soochow University (January 15, 2020– January 14, 2021) was performed and compared with that during the pre-COVID-19 period (January 15, 2019 – January 14, 2020). Patient information including age, sex, length of stay, and death was collected. Wilcoxon Rank sum test was utilized to compare the difference in LOS between the two cohorts. Chi-Squared test was utilized to analyze the prognosis of patients. The LOS and prognosis in different departments (emergency internal medicine, emergency surgery, emergency neurology, and other departments) were further analyzed.
Results

Of the total 8278 patients, 4159 (50.24%) were ordered in the COVID-19 pandemic group and 4119 (49.76%) were ordered in the pre-COVID-19 group. The length of stay prolongs significantly in the COVID-19 group compared with that in the pre-COVID-19 group(13h vs 9.8h; p < 0.001). There was no significant difference in mortality between the two cohorts (4.8% VS 5.3%; p=0.341).
Conclusion

The COVID-19 pandemic was associated with a significant increase in the length of stay, which may lead to emergency department crowding. And the influence of the COVID-19 pandemic on patients in different emergency departments is different. There is no significant impact on the LOS of emergency neuropathy. Across departments, COVID-19 didn’t have a significant impact on the prognosis of ED patients.