Effect of COVID-19 on management of patients with low back pain in the emergency department.

This was a retrospective record review comparing two periods, so it can describe what happened but cannot prove that COVID-19 caused the changes. No patient-reported pain or disability was collected, so symptom severity could not be directly compared between years. Medication data were missing for Canterbury Hospital for March and the first week of April 2019, covering 11% of medicine data. The study included only three Sydney hospitals that were all providing care for patients with COVID-19, so results may not apply to hospitals less affected by the pandemic. The authors did not have detailed clinical information to formally judge whether imaging, opioids, admission or pathology tests were appropriate against care standards. Adverse events during ED care were not recorded.

The study received no specific grant from public, commercial or not-for-profit funders. Chris Maher reported support from Australia's National Health and Medical Research Council fellowships and grants, research grants from government and not-for-profit agencies, free heat wraps from Flexeze for a trial he is an investigator on, and conference expenses covered by professional associations. Adrian Traeger reported National Health and Medical Research Council fellowship and program grant support. The remaining authors declared no conflicts.

Do not read the 31% drop in presentations as evidence that ED care became safer or more guideline-based. Imaging, opioids, admission and pathology testing did not decrease, and ambulance arrivals increased.