ALL ICD 10 DIAGNOSES CODED IN THE EMERGENCY ROOM U07.1
Conditions
Interventions
Group 1: There is no specific intervention as this is an observational study. Primarily, all emergency patients in the pandemic period will be examined.
Sponsors
Charité Universitätsmedizin BerlinNotfall- und Akutmedizin (CVK, CCM)
Eligibility
Sex/Gender
All
Age
0 Years to 120 Years
Inclusion criteria
Inclusion criteria: Inclusion criteria COVID-NA1: - Patient*in one of the participating emergency rooms during the study period: Calendar week 1-16 of the years 2019 and 2020 Inclusion criteria COVID-NA3: - Patient*in the Charité emergency rooms (CCM/CVK) - Emergency visit to one of the two locations between 01.01.2020 and 31.05.2020 or in the reference period 2019 Inclusion criteria COVID-NA3 - qualitative part: - Staff of the emergency departments of Charité Universitätsmedizin Berlin, who were/are involved in the care of patients during the COVID-19 pandemic Inclusion criteria COVID-NA4: - Patients* with a negative Covid-19 test between 01.01.2020 and 19.04.2020 - sufficient German language skills - Accessibility + auditory perception via telephone Inclusion criteria COVID-NA5: - adult patient* (=18 years) - COVID-19 Suspicion at presentation in one of the participating emergency rooms based on the following criteria: Temperature = 38°C - Respiratory symptoms (shortness of breath, coughing, sputum or other symptoms with suspected COVID-19, such as diarrhea, loss of sense of smell, etc.) Inclusion Criteria COVID-NA6: - Inpatient admission from the emergency department (avoid inclusion of patients who are transferred externally). - Indication for SARS-CoV-2 testing as part of routine clinical practice (suspected and screening cases).
Exclusion criteria
Exclusion criteria: Exclusion criteria COVID-NA4: - Patients* with dementia or other cognitive impairments Specific exclusion criteria for telephone interviews - insufficient German language skills or language disorders (aphasia, apraxia, ...) COVID-NA6 exclusion criteria: - A written SARS-CoV-2 PCR test result no more than 48 hours old (no verbally reported test results, no rapid Ag tests). - Patients* with acute major trauma, stroke or myocardial infarction, or planned surgery, intervention, or urgent transfer for other reasons within six hours of admission. - Expected prolonged inpatient stay > 14 days.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| COVID-NA1: - Comparison of case numbers per calendar week 2019 vs. 2020 - Comparison of the utilization of selected specific trigger diagnoses (COPD, myocardial infarction, stroke) - Number of positive test results in relation to the number of Sars-COV-2 tests performed COVID-NA2 and 3: - Characterization of COVID-19 patients and suspected cases - Diagnostic parameters for COVID-19 disease - Prognostic parameters for poor clinical outcome (mortality, intubation, intensive care) - Case number comparison 2019 vs. 2020 - Comparative characterization of the treatment spectrum of emergency patients - Comparison of subsequent general care patterns of all emergency admissions with special consideration of the care patterns of COVID-positive tested patients (proportion of intensive care treatments, estimates of the urgency of treatment, follow-ups, mortality, case type) - Analysis of diagnostic and prognostic factors in suspected COVID-19, also using retained sample material - Staff Perceived Impact of the COVID-19 Pandemic on Emergency Care (structural changes, challenges in patient care, possible changes in treatment processes) - Comparison of clinical parameters and procedures (e.g. previous illnesses, vital parameters, X-ray, CT) COVID-NA4: The aim is to detect Covid-19-associated disease anxiety and persistent impairment due to anxiety symptoms in relation to the SARS-CoV-2 pandemic on the one hand and to quantify the proportion of patients* with an indication of health care use due to Covid-19-associated disease anxiety on the other. COVID-NA5: 1. to evaluate the prognostic significance of clinical and biological parameters measured on admission to the emergency department in patients suspected of having COVID-19 in order to predict the medical endpoints of hospitalization, length of hospital stay, intrahospital mortality and admission to an intensive care unit. COVID-NA6: Investigation of the effect of different test strategies including a point of care test | — |
Secondary
| Measure | Time frame |
|---|---|
| COVID-NA1: - Changes regarding case type/ urgency of treatment 2019 vs. 2020 - Changes in demographic characteristics such as age and gender 2019 vs. 2020 - Possible differences in changes between the years in relation to the clinic structure (e.g. existence of a test center, level of care in the respective emergency room) - Analysis of changes taking into account regional socio-political measures (e.g. school closures, school vacations, travel restrictions) COVID-NA3: - Changes under demographic aspects (age, gender) COVID-NA5: A description of the clinical presentation and clinical course of patients* with suspected COVID-19 in the emergency room. Evaluation of risk scores (CURB-65, Pneumonia Severity Index (PSI), qSOFA and News2) for risk stratification COVID-NA6: Clinical endpoints: Length of inpatient stay, length of emergency department stay, time of test performance in the emergency department, diagnostic value, emergency department processes, staff satisfaction, patient satisfaction, time to transfer, diagnoses, inpatient admission, admission to intensive care unit, length of stay in intensive care unit, mortality. | — |
Countries
Germany
Contacts
Public ContactMartin Möckel
Charité Universitätsmedizin BerlinNotfall- und Akutmedizin (CVK, CCM)
Outcome results
None listed