The impact of COVID-19 pandemic on the urgency of patients admitted to the emergency department.
Arian Zaboli, Francesco Brigo, Serena Sibilio and 5 others
PMID 36327572WHAT IT FOUND
At one Italian ED, orange and red triage trends stayed stable after the pandemic outbreak, while blue and green codes rose, especially as restrictions eased.
More minor presentations appeared, not fewer serious emergencies.
Key findings
01In the pre-post comparison, blue, green, and orange codes increased, yellow decreased, and red did not change significantly.
02In the time-series analysis, orange and red trends did not change significantly around the outbreak.
03Non-urgent visits were associated with pandemic restrictions and reopening: same-week governmental restrictions were associated with lower non-urgent visits, while reopening three weeks earlier was associated with higher non-urgent visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was a single-centre retrospective review from one Italian ED, so the flow may not match other hospitals or countries. The data were not collected for the study in advance, and the accuracy of triage code assignment was not checked. The analysis used triage priority codes only, not final medical diagnoses, so it cannot show whether urgent patients were missed or misclassified. The number of ED patients who were COVID-19 positive during the pandemic period was not known. The weekly analysis was chosen a priori, but the study still relied on ED database counts rather than patient-level explanations for attendance.
Declared interests
The study was not funded, and the authors declared no competing financial interests or personal relationships.
The easy way to misread this
Do not read the rise in non-urgent codes as proof that fewer people needed emergency care. Orange and red time-series trends were stable, and the study used triage codes rather than final diagnoses, so it cannot show missed serious conditions.