Acquired COVID-19 infection in the Emergency Department after its reorganization during the pandemic: single center prospective study

The aim of our study is to evaluate the burden of ED acquired COVID-19 (EDAC) in patients discharged from a reorganized Italian ED during COVID-19 outbreak. This was an observational prospective study approved by the ethical committee conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national). Informed consent was obtained from study patients. Consecutive patients evaluated in ED from 7 to 30 April, 2020, were considered for the study. Thirty days after the index ED visit, patients underwent a structured telephone interview. Furthermore, hospital database research for additional ED visits and hospital admissions was performed. Two expert physicians based on medical chart and follow-up data adjudicated independently the final diagnosis: COVID-19 present or absent. From 7 to 30 April, 2020, 2480 patients attended the ED compared to 7,991 patients that attended the ED in the same period in 2019 (− 69%). During the study period, 118 patients had a diagnosis of COVID-19, of whom 16 (13.6%) were managed for at least 1 h in the no-suspected COVID-19 area. In conclusion, in an ED that experienced a decrease of patients’ attendance during COVID-19 outbreak, that was reorganized in suspected and no-suspected COVID-19 areas, that provided maintenance of patients’ distancing, use of protective equipment for both patients and healthcare workers and rapid admission of highly suspected COVID-19 patients needing hospitalization, there was not encountered any EDAC among patients discharged from ED.