Early prediction of sudden cardiac death risk with Nested LSTM based on electrocardiogram sequential features.

Electrocardiogram (ECG) signals are very important for heart disease diagnosis. In this paper, a novel early prediction method based on Nested Long Short-Term Memory (Nested LSTM) is developed for sudden cardiac death risk detection. First, wavelet denoising and normalization techniques are utilized for reliable reconstruction of ECG signals from extreme noise conditions. Then, a nested LSTM structure is adopted, which can guide the memory forgetting and memory selection of ECG signals, so as to improve the data processing ability and prediction accuracy of ECG signals. To demonstrate the effectiveness of the proposed method, four different models with different signal prediction techniques are used for comparison. The extensive experimental results show that this method can realize an accurate prediction of the cardiac beat's starting point and track the trend of ECG signals effectively. This study holds significant value for timely intervention for patients at risk of sudden cardiac death.

EM-COGLOAD: An investigation into age and cognitive load detection using eye tracking and deep learning.

Alzheimer's Disease is the most prevalent neurodegenerative disease, and is a leading cause of disability among the elderly. Eye movement behaviour demonstrates potential as a non-invasive biomarker for Alzheimer's Disease, with changes detectable at an early stage after initial onset. This paper introduces a new publicly available dataset: EM-COGLOAD (available at https://osf.io/zjtdq/, DOI: 10.17605/OSF.IO/ZJTDQ). A dual-task paradigm was used to create effects of declined cognitive performance in 75 healthy adults as they carried out visual tracking tasks. Their eye movement was recorded, and time series classification of the extracted eye movement traces was explored using a range of deep learning techniques. The results of this showed that convolutional neural networks were able to achieve an accuracy of 87.5% when distinguishing between eye movement under low and high cognitive load, and 76% when distinguishing between the oldest and youngest age groups.

Mix-method toolbox for monitoring greenhouse gas production and microbiome responses to soil amendments.

In this study, we adopt an interdisciplinary approach, integrating agronomic field experiments with soil chemistry, molecular biology techniques, and statistics to investigate the impact of organic residue amendments, such as vinasse (a by-product of sugarcane ethanol production), on soil microbiome and greenhouse gas (GHG) production. The research investigates the effects of distinct disturbances, including organic residue application alone or combined with inorganic N fertilizer on the environment. The methods assess soil microbiome dynamics (composition and function), GHG emissions, and plant productivity. Detailed steps for field experimental setup, soil sampling, soil chemical analyses, determination of bacterial and fungal community diversity, quantification of genes related to nitrification and denitrification pathways, measurement and analysis of gas fluxes (N2O, CH4, and CO2), and determination of plant productivity are provided. The outcomes of the methods are detailed in our publications (Lourenço et al., 2018a; Lourenço et al., 2018b; Lourenço et al., 2019; Lourenço et al., 2020). Additionally, the statistical methods and scripts used for analyzing large datasets are outlined. The aim is to assist researchers by addressing common challenges in large-scale field experiments, offering practical recommendations to avoid common pitfalls, and proposing potential analyses, thereby encouraging collaboration among diverse research groups.•Interdisciplinary methods and scientific questions allow for exploring broader interconnected environmental problems.•The proposed method can serve as a model and protocol for evaluating the impact of soil amendments on soil microbiome, GHG emissions, and plant productivity, promoting more sustainable management practices.•Time-series data can offer detailed insights into specific ecosystems, particularly concerning soil microbiota (taxonomy and functions).

LEET: stock market forecast with long-term emotional change enhanced temporal model.

The stock market serves as a macroeconomic indicator, and stock price forecasting aids investors in analysing market trends and industry dynamics. Several deep learning network models have been proposed and extensively applied for stock price prediction and trading scenarios in recent times. Although numerous studies have indicated a significant correlation between market sentiment and stock prices, the majority of stock price predictions rely solely on historical indicator data, with minimal effort to incorporate sentiment analysis into stock price forecasting. Additionally, many deep learning models struggle with handling the long-distance dependencies of large datasets. This can cause them to overlook unexpected stock price fluctuations that may arise from long-term market sentiment, making it challenging to effectively utilise long-term market sentiment information. To address the aforementioned issues, this investigation suggests implementing a new technique called Long-term Sentiment Change Enhanced Temporal Analysis (LEET) which effectively incorporates long-term market sentiment and enhances the precision of stock price forecasts. The LEET method proposes two market sentiment index estimation methods: Exponential Weighted Sentiment Analysis (EWSA) and Weighted Average Sentiment Analysis (WASA). These methods are utilized to extract the market sentiment index. Additionally, the study proposes a Transformer architecture based on ProbAttention with rotational position encoding for enhanced positional information capture of long-term emotions. The LEET methodology underwent validation using the Standard & Poor's 500 (SP500) and FTSE 100 indices. These indices accurately reflect the state of the US and UK equity markets, respectively. The experimental results obtained from a genuine dataset demonstrate that this method is superior to the majority of deep learning network architectures when it comes to predicting stock prices.

Impact of COVID-19 pandemic on depression incidence and healthcare service use among patients with depression: an interrupted time-series analysis from a 9-year population-based study.

BACKGROUND: Most studies on the impact of the COVID-19 pandemic on depression burden focused on the earlier pandemic phase specific to lockdowns, but the longer-term impact of the pandemic is less well-studied. In this population-based cohort study, we examined the short-term and long-term impacts of COVID-19 on depression incidence and healthcare service use among patients with depression. METHODS: Using the territory-wide electronic medical records in Hong Kong, we identified all patients aged ≥ 10 years with new diagnoses of depression from 2014 to 2022. We performed an interrupted time-series (ITS) analysis to examine changes in incidence of medically attended depression before and during the pandemic. We then divided all patients into nine cohorts based on year of depression incidence and studied their initial and ongoing service use patterns until the end of 2022. We applied generalized linear modeling to compare the rates of healthcare service use in the year of diagnosis between patients newly diagnosed before and during the pandemic. A separate ITS analysis explored the pandemic impact on the ongoing service use among prevalent patients with depression. RESULTS: We found an immediate increase in depression incidence (RR = 1.21, 95% CI: 1.10-1.33, p < 0.001) in the population after the pandemic began with non-significant slope change, suggesting a sustained effect until the end of 2022. Subgroup analysis showed that the increases in incidence were significant among adults and the older population, but not adolescents. Depression patients newly diagnosed during the pandemic used 11% fewer resources than the pre-pandemic patients in the first diagnosis year. Pre-existing depression patients also had an immediate decrease of 16% in overall all-cause service use since the pandemic, with a positive slope change indicating a gradual rebound over a 3-year period. CONCLUSIONS: During the pandemic, service provision for depression was suboptimal in the face of increased demand generated by the increasing depression incidence during the COVID-19 pandemic. Our findings indicate the need to improve mental health resource planning preparedness for future public health crises.

Changes in the number of new takeaway food outlets associated with adoption of management zones around schools: A natural experimental evaluation in England.

By the end of 2017, 35 local authorities (LAs) across England had adopted takeaway management zones (or "exclusion zones") around schools as a means to curb proliferation of new takeaways. In this nationwide, natural experimental study, we evaluated the impact of management zones on takeaway retail, including unintended displacement of takeaways to areas immediately beyond management zones, and impacts on chain fast-food outlets. We used uncontrolled interrupted time series analyses to estimate changes from up to six years pre- and post-adoption of takeaway management zones around schools. We evaluated three outcomes: mean number of new takeaways within management zones (and by three identified sub-types: full management, town centre exempt and time management zones); mean number on the periphery of management zones (i.e. within an additional 100 m of the edge of zones); and presence of new chain fast-food outlets within management zones. For 26 LAs, we observed an overall decrease in the number of new takeaways opening within management zones. Six years post-intervention, we observed 0.83 (95% CI -0.30, -1.03) fewer new outlets opening per LA than would have been expected in absence of the intervention, equivalent to an 81.0% (95% CI -29.1, -100) reduction in the number of new outlets. Cumulatively, 12 (54%) fewer new takeaways opened than would have been expected over the six-year post-intervention period. When stratified by policy type, effects were most prominent for full management zones and town centre exempt zones. Estimates of intervention effects on numbers of new takeaways on the periphery of management zones, and on the presence of new chain fast-food outlets within management zones, did not meet statistical significance. Our findings suggest that management zone policies were able to demonstrably curb the proliferation of new takeaways. Modelling studies are required to measure the possible population health impacts associated with this change.

Short-term association of particulate matter and cardiovascular disease mortality in Shanghai, China between 2003 and 2020.

Objective: Evidence regarding the effects of particulate matter (PM) pollutants on cardiovascular disease (CVD) mortality remains limited in Shanghai, China. Our objective was to thoroughly evaluate associations between PM pollutants and CVD mortality. Methods: Daily data on CVD mortality, PM (PM10 and PM2.5) pollutants, and meteorological variables in Shanghai, China were gathered from 2003 to 2020. We utilized a time-series design with the generalized additive model to assess associations between PM pollutants and CVD mortality. Additionally, we conducted stratified analyses based on sex, age, education, and seasons using the same model. Results: We found that PM pollutants had a significant association with CVD mortality during the study period. Specifically, there was a 0.29% (95%CI: 0.14, 0.44) increase in CVD mortality for every 10 µg/m3 rise in a 2-day average (lag01) concentration of PM10. A 0.28% (95% CI: 0.07, 0.49) increase in CVD mortality was associated with every 10 µg/m3 rise in PM2.5 concentration at lag01. Overall, the estimated effects of PM10 and PM2.5 were larger in the warm period compared with the cold period. Furthermore, males and the older adult exhibited greater susceptibility to PM10 and PM2.5 exposure, and individuals with lower education levels experienced more significant effects from PM10 and PM2.5 than those with higher education levels. Conclusion: Our findings suggested that PM pollutants have a substantial impact on increasing CVD mortality in Shanghai, China. Moreover, the impacts of air pollution on health may be altered by factors such as season, sex, age, and educational levels.

PyDTS: A Python Toolkit for Deep Learning Time Series Modelling.

In this article, the topic of time series modelling is discussed. It highlights the criticality of analysing and forecasting time series data across various sectors, identifying five primary application areas: denoising, forecasting, nonlinear transient modelling, anomaly detection, and degradation modelling. It further outlines the mathematical frameworks employed in a time series modelling task, categorizing them into statistical, linear algebra, and machine- or deep-learning-based approaches, with each category serving distinct dimensions and complexities of time series problems. Additionally, the article reviews the extensive literature on time series modelling, covering statistical processes, state space representations, and machine and deep learning applications in various fields. The unique contribution of this work lies in its presentation of a Python-based toolkit for time series modelling (PyDTS) that integrates popular methodologies and offers practical examples and benchmarking across diverse datasets.

Time-Varying GPS Displacement Network Modeling by Sequential Monte Carlo.

Geodetic observations through high-rate GPS time-series data allow the precise modeling of slow ground deformation at the millimeter level. However, significant attention has been devoted to utilizing these data for various earth science applications, including to determine crustal velocity fields and to detect significant displacement from earthquakes. The relationships inherent in these GPS displacement observations have not been fully explored. This study employs the sequential Monte Carlo method, specifically particle filtering (PF), to develop a time-varying analysis of the relationships among GPS displacement time-series within a network, with the aim of uncovering network dynamics. Additionally, we introduce a proposed graph representation to enhance the understanding of these relationships. Using the 1-Hz GEONET GNSS network data of the Tohoku-Oki Mw9.0 2011 as a demonstration, the results demonstrate successful parameter tracking that clarifies the observations' underlying dynamics. These findings have potential applications in detecting anomalous displacements in the future.

Distinction of Chaos from Randomness Is Not Possible from the Degree Distribution of the Visibility and Phase Space Reconstruction Graphs.

We investigate whether it is possible to distinguish chaotic time series from random time series using network theory. In this perspective, we selected four methods to generate graphs from time series: the natural, the horizontal, the limited penetrable horizontal visibility graph, and the phase space reconstruction method. These methods claim that the distinction of chaos from randomness is possible by studying the degree distribution of the generated graphs. We evaluated these methods by computing the results for chaotic time series from the 2D Torus Automorphisms, the chaotic Lorenz system, and a random sequence derived from the normal distribution. Although the results confirm previous studies, we found that the distinction of chaos from randomness is not generally possible in the context of the above methodologies.

Time-series analysis of rhenium(I) organometallic covalent binding to a model protein for drug development.

Metal-based complexes with their unique chemical properties, including multiple oxidation states, radio-nuclear capabilities and various coordination geometries yield value as potential pharmaceuticals. Understanding the interactions between metals and biological systems will prove key for site-specific coordination of new metal-based lead compounds. This study merges the concepts of target coordination with fragment-based drug methodologies, supported by varying the anomalous scattering of rhenium along with infrared spectroscopy, and has identified rhenium metal sites bound covalently with two amino acid types within the model protein. A time-based series of lysozyme-rhenium-imidazole (HEWL-Re-Imi) crystals was analysed systematically over a span of 38 weeks. The main rhenium covalent coordination is observed at His15, Asp101 and Asp119. Weak (i.e. noncovalent) interactions are observed at other aspartic, asparagine, proline, tyrosine and tryptophan side chains. Detailed bond distance comparisons, including precision estimates, are reported, utilizing the diffraction precision index supplemented with small-molecule data from the Cambridge Structural Database. Key findings include changes in the protein structure induced at the rhenium metal binding site, not observed in similar metal-free structures. The binding sites are typically found along the solvent-channel-accessible protein surface. The three primary covalent metal binding sites are consistent throughout the time series, whereas binding to neighbouring amino acid residues changes through the time series. Co-crystallization was used, consistently yielding crystals four days after setup. After crystal formation, soaking of the compound into the crystal over 38 weeks is continued and explains these structural adjustments. It is the covalent bond stability at the three sites, their proximity to the solvent channel and the movement of residues to accommodate the metal that are important, and may prove useful for future radiopharmaceutical development including target modification.

The Oryza sativa transcriptome responds spatiotemporally to polystyrene nanoplastic stress.

Nanoplastic represents an emerging abiotic stress facing modern agriculture, impacting global crop production. However, the molecular response of crop plants to this stress remains poorly understood at a spatiotemporal resolution. We therefore used RNA sequencing to profile the transcriptome expressed in rice (Oryza sativa) root and leaf organs at 1, 2, 4, and 8 d post exposure with nanoplastic. We revealed a striking similarity between the rice biomass dynamics in aboveground parts to that in belowground parts during nanoplastic stress, but transcriptome did not. At the global transcriptomic level, a total of 2332 differentially expressed genes were identified, with the majority being spatiotemporal specific, reflecting that nanoplastics predominantly regulate three processes in rice seedlings: (1) down-regulation of chlorophyll biosynthesis, photosynthesis, and starch, sucrose and nitrogen metabolism, (2) activation of defense responses such as brassinosteroid biosynthesis and phenylpropanoid biosynthesis, and (3) modulation of jasmonic acid and cytokinin signaling pathways by transcription factors. Notably, the genes involved in plant-pathogen interaction were shown to be successively modulated by both root and leaf organs, particularly plant disease defense genes (OsWRKY24, OsWRKY53, Os4CL3, OsPAL4, and MPK5), possibly indicating that nanoplastics affect rice growth indirectly through other biota. Finally, we associated biomass phenotypes with the temporal reprogramming of rice transcriptome by weighted gene co-expression network analysis, noting a significantly correlation with photosynthesis, carbon metabolism, and phenylpropanoid biosynthesis that may reflect the mechanisms of biomass reduction. Functional analysis further identified PsbY, MYB, cytochrome P450, and AP2/ERF as hub genes governing these pathways. Overall, our work provides the understanding of molecular mechanisms of rice in response to nanoplastics, which in turn suggests how rice might behave in a nanoplastic pollution scenario.

Impact of climate change on dengue incidence in Singapore: time-series seasonal analysis.

This study aimed to identify the meteorological factors that contribute to dengue epidemics. The monthly incidence of dengue was used as the outcome variable, while maximum temperature, humidity, precipitation, and sunshine hours were used as independent variables. The results showed a consistent increase in monthly dengue cases from 2013 to 2021, with seasonal patterns observed in stationary time-series data. The ARIMA (2, 1, 3) × seasonal (0, 1, 2)12 model was used based on its lowest Akaike Information Criterion (AIC) values. The analysis revealed that a 1-unit increase in rainfall was positively correlated with a small 0.062-unit increase in dengue cases, whereas a 1-unit increase in humidity was negatively associated, leading to a substantial reduction of approximately 16.34 cases. This study highlights the importance of incorporating weather data into national dengue prevention programs to enhance public awareness and to promote recommended safety measures.

[Spatial Distribution Characteristics of PM2.5 and O3 in Beijing-Tianjin-Hebei Region Based on Time Series Decomposition].

Notably, clear spatial differences occur in the distribution of air pollution among cities in the Beijing-Tianjin-Hebei (BTH) Region. Clarifying the concentration distribution of PM2.5 and O3 at different time scales is helpful to formulate scientific and effective pollution prevention and control measures. Here, the concentrations of PM2.5 and O3 were decomposed using a seasonal-trend decomposition procedure based on the loess (STL) method; their long-term, seasonal, and short-term components were obtained; and their temporal and spatial distribution characteristics were studied. The results showed that the decrease in PM2.5 concentration in the BTH Region from 2017 to 2021 was higher than that of O3. There was a positive correlation between PM2.5 and O3 concentrations in spring and summer and a negative correlation in autumn and winter. The short-term component and seasonal component had the greatest contribution to PM2.5 and O3 concentrations, respectively. There were two principal components in the seasonal and short-term components of PM2.5 and the long-term and short-term components of O3, corresponding to the central and southern part of Hebei Province and the northern part of the BTH Region. Sub-regional distribution of PM2.5 and O3 in the BTH Region at different time scales were found. Compared with that in the original series, the long-term component could better reflect the evolution trend of PM2.5 and O3 concentrations, and the standard deviation (SD) of the seasonal component and short-term component could be used to measure the fluctuation in PM2.5 and O3 concentrations in various cities. The SD of the seasonal and short-term components of the PM2.5 concentration in every city in front of Taihang Mountain was higher, and the SD of the short-term component of the O3 concentration in Tangshan was the highest.

High response diversity and conspecific density-dependence, not species interactions, drive dynamics of coral reef fish communities.

Species-to-species and species-to-environment interactions are key drivers of community dynamics. Disentangling these drivers in species-rich assemblages is challenging due to the high number of potentially interacting species (the 'curse of dimensionality'). We develop a process-based model that quantifies how intraspecific and interspecific interactions, and species' covarying responses to environmental fluctuations, jointly drive community dynamics. We fit the model to reef fish abundance time series from 41 reefs of Australia's Great Barrier Reef. We found that fluctuating relative abundances are driven by species' heterogenous responses to environmental fluctuations, whereas interspecific interactions are negligible. Species differences in long-term average abundances are driven by interspecific variation in the magnitudes of both conspecific density-dependence and density-independent growth rates. This study introduces a novel approach to overcoming the curse of dimensionality, which reveals highly individualistic dynamics in coral reef fish communities that imply a high level of niche structure.

Time-Varying Network Models for the Temporal Dynamics of Depressive Symptomatology in Patients With Depressive Disorders: Secondary Analysis of Longitudinal Observational Data.

BACKGROUND: As depression is highly heterogenous, an increasing number of studies investigate person-specific associations of depressive symptoms in longitudinal data. However, most studies in this area of research conceptualize symptom interrelations to be static and time invariant, which may lead to important temporal features of the disorder being missed. OBJECTIVE: To reveal the dynamic nature of depression, we aimed to use a recently developed technique to investigate whether and how associations among depressive symptoms change over time. METHODS: Using daily data (mean length 274, SD 82 d) of 20 participants with depression, we modeled idiographic associations among depressive symptoms, rumination, sleep, and quantity and quality of social contacts as dynamic networks using time-varying vector autoregressive models. RESULTS: The resulting models showed marked interindividual and intraindividual differences. For some participants, associations among variables changed in the span of some weeks, whereas they stayed stable over months for others. Our results further indicated nonstationarity in all participants. CONCLUSIONS: Idiographic symptom networks can provide insights into the temporal course of mental disorders and open new avenues of research for the study of the development and stability of psychopathological processes.

Data pipeline for real-time energy consumption data management and prediction.

With the increasing utilization of data in various industries and applications, constructing an efficient data pipeline has become crucial. In this study, we propose a machine learning operations-centric data pipeline specifically designed for an energy consumption management system. This pipeline seamlessly integrates the machine learning model with real-time data management and prediction capabilities. The overall architecture of our proposed pipeline comprises several key components, including Kafka, InfluxDB, Telegraf, Zookeeper, and Grafana. To enable accurate energy consumption predictions, we adopt two time-series prediction models, long short-term memory (LSTM), and seasonal autoregressive integrated moving average (SARIMA). Our analysis reveals a clear trade-off between speed and accuracy, where SARIMA exhibits faster model learning time while LSTM outperforms SARIMA in prediction accuracy. To validate the effectiveness of our pipeline, we measure the overall processing time by optimizing the configuration of Telegraf, which directly impacts the load in the pipeline. The results are promising, as our pipeline achieves an average end-to-end processing time of only 0.39 s for handling 10,000 data records and an impressive 1.26 s when scaling up to 100,000 records. This indicates 30.69-90.88 times faster processing compared to the existing Python-based approach. Additionally, when the number of records increases by ten times, the increased overhead is reduced by 3.07 times. This verifies that the proposed pipeline exhibits an efficient and scalable structure suitable for real-time environments.

Impact of COVID-19 pandemic on the number of otolaryngologic surgeries in Japan.

OBJECTIVE: Previous studies show that the COVID-19 pandemic affected the number of surgeries performed. However, data on the association between the COVID-19 pandemic and otolaryngologic surgeries according to subspecialties are lacking. This study was performed to evaluate the impact of the COVID-19 pandemic on various types of otolaryngologic surgeries. METHODS: We retrospectively identified patients who underwent otolaryngologic surgeries from April 2018 to February 2021 using a Japanese national inpatient database. We performed interrupted time-series analyses before and after April 2020 to evaluate the number of otolaryngologic surgeries performed. The Japanese government declared its first state of emergency during the COVID-19 pandemic in April 2020. RESULTS: We obtained data on 348,351 otolaryngologic surgeries. Interrupted time-series analysis showed a significant decrease in the number of overall otolaryngologic surgeries in April 2020 (-3619 surgeries per month; 95% confidence interval, -5555 to -1683; p < 0.001). Removal of foreign bodies and head and neck cancer surgery were not affected by the COVID-19 pandemic. In the post-COVID-19 period, the number of otolaryngologic surgeries, except for ear and upper airway surgeries, increased significantly. The number of tracheostomies and peritonsillar abscess incisions did not significantly decrease during the COVID-19 pandemic. CONCLUSION: The COVID-19 pandemic was associated with a decrease in the overall number of otolaryngologic surgeries, but the trend differed among subspecialties.

Changes in the number and outcome of takeaway food outlet planning applications in response to adoption of management zones around schools in England: A time series analysis.

Physical exposure to takeaway food outlets ("takeaways") is associated with poor diet and excess weight, which are leading causes of excess morbidity and mortality. At the end of 2017, 35 local authorities (LAs) in England had adopted takeaway management zones (or "exclusion zones"), which is an urban planning intervention designed to reduce physical exposure to takeaways around schools. In this nationwide, natural experimental study, we used interrupted time series analyses to estimate the impact of this intervention on changes in the total number of takeaway planning applications received by LAs and the percentage rejected, at both first decision and after any appeal, within management zones, per quarter of calendar year. Changes in these proximal process measures would precede downstream retail and health impacts. We observed an overall decrease in the number of applications received by intervention LAs at 12 months post-intervention (6.3 fewer, 95% CI -0.1, -12.5), and an increase in the percentage of applications that were rejected at first (additional 18.8%, 95% CI 3.7, 33.9) and final (additional 19.6%, 95% CI 4.7, 34.6) decision, the latter taking into account any appeal outcomes. This effect size for the number of planning applications was maintained at 24 months, although it was not statistically significant. We also identified three distinct sub-types of management zone regulations (full, town centre exempt, and time management zones). The changes observed in rejections were most prominent for full management zones (where the regulations are applied irrespective of overlap with town centres), where the percentage of applications rejected was increased by an additional 46.1% at 24 months. Our findings suggest that takeaway management zone policies may have the potential to curb the proliferation of new takeaways near schools and subsequently impact on population health.

Impact of the early phase of the COVID-19 pandemic on emergency department-to-intensive care unit admissions in Korea: an interrupted time-series analysis.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic resulted in significant disruptions to critical care systems globally. However, research on the impact of the COVID-19 pandemic on intensive care unit (ICU) admissions via the emergency department (ED) is limited. Therefore, this study evaluated the changes in the number of ED-to-ICU admissions and clinical outcomes in the periods before and during the pandemic. METHODS: We identified all adult patients admitted to the ICU through level 1 or 2 EDs in Korea between February 2018 and January 2021. February 2020 was considered the onset point of the COVID-19 pandemic. The monthly changes in the number of ED-to-ICU admissions and the in-hospital mortality rates before and during the COVID-19 pandemic were evaluated using interrupted time-series analysis. RESULTS: Among the 555,793 adult ED-to-ICU admissions, the number of ED-to-ICU admissions during the pandemic decreased compared to that before the pandemic (step change, 0.916; 95% confidence interval [CI] 0.869-0.966], although the trend did not attain statistical significance (slope change, 0.997; 95% CI 0.991-1.003). The proportion of patients who arrived by emergency medical services, those transferred from other hospitals, and those with injuries declined significantly among the number of ED-to-ICU admissions during the pandemic. The proportion of in-hospital deaths significantly increased during the pandemic (step change, 1.054; 95% CI 1.003-1.108); however, the trend did not attain statistical significance (slope change, 1.001; 95% CI 0.996-1.007). Mortality rates in patients with an ED length of stay of ≥ 6 h until admission to the ICU rose abruptly following the onset of the pandemic (step change, 1.169; 95% CI 1.021-1.339). CONCLUSIONS: The COVID-19 pandemic significantly affected ED-to-ICU admission and in-hospital mortality rates in Korea. This study's findings have important implications for healthcare providers and policymakers planning the management of future outbreaks of infectious diseases. Strategies are needed to address the challenges posed by pandemics and improve the outcomes in critically ill patients.