Re-presentations to the emergency department initial presentation with COVID-19: Insights from the omicron wave

Abstract

Background

Relapsing symptoms post-SARS-CoV-2 (COVID) infection, particularly with variants like Omicron, remain poorly understood and cumulative mortality rates are in the millions worldwide. Re-presentation rates to emergency departments (ED) post initial presentation are poorly defined.

Objectives

To identify the frequency and characteristics of ED re-presentations during the six months post initial COVID-19 admission.

Methodology

A retrospective chart review of patients with a positive COVID-19 PCR result and initial ED presentation at the Austin hospital in Victoria, Australia during January–February 2022 (wave one) and March–April 2022 (wave two). Subsequent ED re-presentations up to six months from initial admission were analyzed, concentrating on symptoms, diagnoses and mortalities.

Results

Of 926 wave one patients meeting the inclusion criteria, 162 (18 %) had subsequent ED presentations. For wave two, out of 556 patients, 129 (23 %) had re-presentations. The highest number of re-presentations for an individual were 24 and 11 for waves one and two respectively. Shortness of breath was the most common symptom for re-presentation during both waves (21 % and 19 % respectively), followed by cough. Additionally, 79 % of wave one patients and 29 % of wave two patients had respiratory-related comorbidities. Twelve percent of patients died within six months of the initial COVID-19 related presentation in wave one compared to 7 % in wave two.

Conclusion

Re-presentation rates were similar to previous COVID waves with the alpha and delta variants. Respiratory symptoms and related diagnoses were common. Strengthening public health strategies is vital to curb transmission, alleviate strain on hospitals, and prevent further morbidity and mortality.