A Study on Behalf of the CCEDRRN: Trends in COVID-19 ED management and outcomes, wave-by-wave.

In Infographics by Corinne HohlLeave a Comment

In 2020, coronavirus disease 2019 (COVID-19) presented the largest public health crisis in
over a century. Healthcare workers had to learn how to treat and manage patients with
COVID-2019 without overwhelming health systems. They were faced with both evidence-
based and non-evidence-based treatment recommendations. Simultaneously, public health
interventions aimed to reduce transmission in the population and protect those most
vulnerable. In this evolving context, we wanted to know whether clinicians were able to
adapt their clinical practice. We also wanted to examine patient outcomes associated with
these changes.

We used data from 46 sites in 8 provinces collected in the CCEDRRN registry and
compared treatments and outcomes of 3,336 patients who presented during wave 1 (before
June 30, 2020) with 6,631 patients who presented in wave 2 (after July 1, 2020). We were able
to adjust for important baseline differences between these patient groups, which would have
made the comparison of groups unequal.

Our results showed that clinicians incorporated the use of steroids into clinical practice very
quickly and abandoned the use of unproven therapies thought to be harmful. Fewer patients
were intubated and placed on mechanical ventilators in wave 2, and fewer needed to be
admitted to hospital or to critical care. Overall, we found that clinicians were able to make
these changes safely, without more patients dying.

CJEM visual abstract

Ultimately, this study speaks to great advances taken in the ED treatment of patients with COVID-19, and how these strategies create health system efficiencies without compromising patient outcomes. I’m excited to ride this positive perspective on COVID-19, and looking forward to seeing more from the CCEDRRN through the rest of 2022.

This post was copy-edited by Sam Wilson, MD (Twitter: @samwilson_95)

Corinne Hohl

Corinne is an Associate Professor in UBC’s Department of Emergency Medicine and a Scientist at the Centre for Clinical Epidemiology and Evaluation. Her main research interests are in emergency medicine, drug safety and effectiveness, and adverse drug event surveillance. Dr. Hohl is also the Principal Investigator for the Canadian COVID-19 Rapid Response Network (CCEDRRN).

Samuel Wilson

Sam is a third-year Emergency Medicine FRCPC resident at The Ottawa Hospital. He is the CanadiEM/CJEM Infographic editor, interested in PoCUS, trauma, knowledge dissemination, and all things chess.

Daniel Ting

Daniel Ting is an Emergency Physician and Clinical Assistant Professor at the University of British Columbia, based in Vancouver. He is the Editor-in-Chief of CanadiEM and a Decision Editor at the Canadian Journal of Emergency Medicine. He completed the CanadiEM Digital Scholarship Fellowship in 2017-18. No conflicts of interest (COI).