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ED Acuity in Patients with Respiratory Complaint During the
COVID-19 Pandemic: A Single-center Experience
Presented by: 
Michael Abala.jpeg
Michael Anthony Abala
Medical Student
College of Medicine
California Northstate University
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Michael Anthony Abala, BS; Simranjeet Benipal, BS; Jose Puglisi, PhD; and Leonard Ranasinghe, MD, PhD

College of Medicine, California Northstate University, Elk Grove, CA


In response to the novel coronavirus (COVID-19) pandemic, “shelter-in-place” (SIP) orders were implemented across the country to control the spread of this respiratory infection and decrease the burden on hospitals in the United States. Our objective was to assess changes in emergency department (ED) volume and acuity in patients with a respiratory complaint in a single center in Los Angeles county, California during the pandemic with respect to the SIP order. We conducted a single-center retrospective review using de-identified data from patients presenting to the ED with a respiratory complaint from December 2019 to May 2020. We examined the monthly distribution of triage levels, as defined by the Emergency Severity Index, as an approximation of general acuity and resource utilization. We also examined the monthly ED volumes of patients presenting with a respiratory complaint and its relationship to overall ED volume. We then compared these data in the periods before and after the implementation of SIP in Los Angeles county, California on March 23, 2020. A significant decrease in absolute (56%) and relative ED volume (12.7% to 10.4%) in patients with respiratory complaint post-SIP declaration was observed (p<0.01). Despite this, increased acuity was observed after the SIP order was enacted (p<0.01), suggesting that those coming to the ED for respiratory complaints were generally sicker, and needed more resources to be properly cared for.


Keywords: Public Health, Emergency Medicine, COVID-19

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