Impact of the COVID-19 Pandemic on Emergency Department Practices for Cardiopulmonary Symptoms

Objectives: The purpose of this study was to evaluate the trends and changes in the time to medical imaging in the emergency department (ED) for patients with cardiopulmonary symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The retrospective observational study was conducted from the clinical database of a tertiary academic teaching hospital. Patients with cardiopulmonary symptoms (chest pain, dyspnea, palpitation and syncope) who visited an adult ED between January 2018 and December 2021 were included. The primary outcome was the time to medical imaging, including chest X-ray (CXR), chest computed tomography (CT), and focused cardiac ultrasound (FOCUS). The primary exposure was the date of the ED visit during the COVID-19 pandemic (from 1 March 2020 to 31 December 2021). Results: Among the 28,213 patients, 17,260 (61.2%) were in the pre-COVID-19 group, and 10,953 (38.8%) were in the COVID-19 group. The time to medical imaging was delayed in the COVID-19 group compared with the pre-COVID-19 group: the time to FOCUS was 9 min, the time to CXR was 6 min, and the time to chest CT was 115 min. Conclusions: We found that the time to medical imaging for patients with cardiopulmonary symptoms who visited the ED was significantly delayed during the COVID-19 pandemic.