Observational studyCJEM2022
Treatments, resource utilization, and outcomes of COVID-19 patients presenting to emergency departments across pandemic waves: an observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN).
Observational study in CJEM, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04702945 (Canadian COVID-19 Emergency Department Rapid Response Network), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) - Population-based Registry of Suspected and Confirmed COVID-19 Cases
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic literature review on public health and healthcare resources for pandemic preparedness planning.BMC public health · 2024Pooled it
- The association between neighbourhood marginalization and SARS-CoV-2 outcomes in patients presenting to emergency departments.Canadian journal of public health = Revue canadienne de sante publique · 2025Observational
- Outcomes for people experiencing homelessness with COVID-19 presenting to emergency departments in Canada, compared with housed patients.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- The Impact of the COVID-19 Pandemic on Mortality Rates From Non-Communicable Chronic Diseases in Taiwan: An Interventional Time Series Study.International journal of public health · 2025Article
- Observational
- Post-COVID-19 condition symptoms among emergency department patients tested for SARS-CoV-2 infection.Nature communications · 2024Article
- The response of Canada's clinical health research ecosystem to the COVID-19 pandemic.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Administrative data ICD-10 diagnostic codes identifies most lab-confirmed SARS-CoV-2 admissions but misses many discharged from the Emergency Department.Scientific reports · 2024Article
- Covariate adjustment in Bayesian adaptive randomized controlled trials.Statistical methods in medical research · 2024Article
- Heatstroke presentations to urban hospitals during BC's extreme heat event: lessons for the future.CJEM · 2024Review
- Transitions of care for older adults discharged home from the emergency department: an inductive thematic content analysis of patient comments.BMC geriatrics · 2024Observational
- Analysis of the Prognosis Outcomes and Treatment Delay Among ST-Segment Elevation Myocardial Infarction Patients in Emergency Department Based on the Presence of Symptoms Suggestive of COVID-19.International journal of health policy and management · 2024Observational
- Understanding the impacts of the COVID-19 pandemic on the care experiences of people with mental-physical multimorbidity: protocol for a mixed methods study.BMC primary care · 2023Article
- Causes of Death Among Medical ICU Patients With Pneumonia Due to COVID-19 in a Safety-Net Hospital.Critical care explorations · 2023Article
- Research recruitment and consent methods in a pandemic: a qualitative study of COVID-19 patients' perspectives.BMC medical research methodology · 2023Article
- Decisions and Decisional Needs of Canadians From all Provinces and Territories During the COVID-19 Pandemic: Population-Based Cross-sectional Surveys.JMIR public health and surveillance · 2023Article
- Clinical Characteristics and Outcomes of Patients with Acute Respiratory Failure Due to SARS-CoV-2 Interstitial Pneumonia Treated with CPAP in a Medical Intermediate Care Setting: A Retrospective Observational Study on Comparison of Four Waves.Journal of clinical medicine · 2023Article
- Derivation and validation of a clinical decision rule to risk-stratify COVID-19 patients discharged from the emergency department: The CCEDRRN COVID discharge score.Journal of the American College of Emergency Physicians open · 2022Article
- Sensitivity and Diagnostic Yield of the First SARS-CoV-2 Nucleic Acid Amplification Test Performed for Patients Presenting to the Hospital.JAMA network open · 2022Article
- Article
Corrections and comments
- Erratum issued
Authors and funding
17 authors.
Funding
Abstract
backgroundTreatment for coronavirus disease 2019 (COVID-19) evolved between pandemic waves. Our objective was to compare treatments, acute care utilization, and outcomes of COVID-19 patients presenting to emergency departments (ED) across pandemic waves.
methodsThis observational study enrolled consecutive eligible COVID-19 patients presenting to 46 EDs participating in the Canadian COVID-19 ED Rapid Response Network (CCEDRRN) between March 1 and December 31, 2020. We collected data by retrospective chart review. Our primary outcome was in-hospital mortality. Secondary outcomes included treatments, hospital and ICU admissions, ED revisits and readmissions. Logistic regression modeling assessed the impact of pandemic wave on outcomes.
resultsWe enrolled 9,967 patients in 8 provinces, 3,336 from the first and 6,631 from the second wave. Patients in the second wave were younger, fewer met criteria for severe COVID-19, and more were discharged from the ED. Adjusted for patient characteristics and disease severity, steroid use increased (odds ratio [OR] 7.4; 95% confidence interval [CI] 6.2-8.9), and invasive mechanical ventilation decreased (OR 0.5; 95% CI 0.4-0.7) in the second wave compared to the first. After adjusting for differences in patient characteristics and disease severity, the odds of hospitalization (OR 0.7; 95% CI 0.6-0.8) and critical care admission (OR 0.7; 95% CI 0.6-0.9) decreased, while mortality remained unchanged (OR 0.7; 95% CI 0.5-1.1).
interpretationIn patients presenting to cute care facilities, we observed rapid uptake of evidence-based therapies and less use of experimental therapies in the second wave. We observed increased rates of ED discharges and lower hospital and critical care resource use over time. Substantial reductions in mechanical ventilation were not associated with increasing mortality. Advances in treatment strategies created health system efficiencies without compromising patient outcomes.
trial registrationClinicaltrials.gov, NCT04702945.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.