Retrospective Study to Identify Risk Factors for Severe Disease and Mortality Using the Modified Early Warning Score in 5127 Patients with COVID-19 Admitted to an Emergency Department in Poland Between March 2020 and April 2021.

BACKGROUND COVID-19, a disease caused by SARS-CoV-2, has posed a threat to global public health. This retrospective study of 5127 patients with COVID-19 admitted to an Emergency Department in Poland between March 2020 and April 2021 aimed to identify risk factors for severe disease and mortality using the modified early warning score (MEWS). MATERIAL AND METHODS The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to the Emergency Department between March 2020 and April 2021. A total of 5127 cases were included in the final analysis. Identifying the group of high-risk patients with COVID-19 was determined based on the MEWS score. RESULTS Most of the patients studied were male (53.38%). The in-hospital mortality rate among the patients was 21.53%. The factors associated with the risk of in-hospital mortality from COVID-19 were age (>60 years, hazard ratio [HR]=2.27, P<0.001), comorbidities (cancer, HR=1.39, P=0.005; heart failure, HR=1.31, P=0.009; renal failure, HR=1.37, P=0.004), higher MEWS score (MEWS ≥5, HR=1.43, P<0.001), higher percentage of lung parenchyma affected (>50%, HR=2.10, P=0.001), and higher respiratory rate (>24 breaths per min, HR=2.10, P<0.001). CONCLUSIONS This study produced real-world data of risk factors for mortality from COVID-19 and the use of the MEWS for a faster identification of patients with COVID-19 requiring more intensive medical care.

Patient Management in the Emergency Department during a COVID-19 Pandemic.

In the wake of the COVID-19 pandemic, international action has been taken to prevent the spread of the disease. The aim of this study is to establish the impact of the COVID-19 pandemic on emergency department utilization patterns in Poland. It was established that age (among COVID-19 positive patients) has a large influence on the occurrence of a mental illness or disorder. It has been proven that the older the person (patients diagnosed with U07.1), the more often mental diseases/disorders are diagnosed (p = 0.009-0.044). Gender decides the course of hospitalization to the disadvantage of men (p = 0.022). Men diagnosed with U07.1 stay much longer in specialized long-term care units. Lower-aged patients have a shorter hospitalization time (up to the age of 29; p = 0.017). The COVID-19 pandemic has placed healthcare systems, their staff, and their patients in an unprecedented situation. Our study showed changes in the number and characteristics of patients visiting the ED during COVID-19. Despite the shift in the center of gravity of health system functioning to the treatment of SARS-CoV-2 infected patients, care must be taken to ensure that uninfected patients have access to treatment for cardiovascular, mental health, oncological, and other diseases.

[Analysis of medical rescue operations performed by medical rescue teams from all over poland in patients with burn wounds].

OBJECTIVE: Introduction: A burn is a superficial or deep tissue damage caused by the action of: heat (high temperature), chemicals, electric current, solar rays and ionizing radiation. The aim: To analyze the trips of emergency medical teams in the period from November 1, 2017 to April 30, 2018 to patients diagnosed with burns throughout the country. PATIENTS AND METHODS: Materials and methods: The analysis covers the whole of Poland, all medical rescue teams. The obtained data comes from the System of Supporting the State Medical Rescue System. The analysis includes the characteristics of the population studied and the medicines used. The study included those that ended with the diagnosis of burns (T-20 to T-32). Taking into account the above criteria, 547 cases were obtained. RESULTS: Results: In 321 cases, there were women and 226 cases of men (58.68% vs 41.32%, p<0.001). More often, it referred to patients over 18 (317 cases vs. 193 below 18 years of age, p<0.001) in 37 cases no data. Most events were recorded in the Masovian and Silesian voivodships (12.97% and 11.33%) and the least in Podlasin (2.92%). In 20.47% of cases, pain treatment was applied, of which in the group of adults in 25.23% vs. 1658% in children, p<0.001. CONCLUSION: Conclusions: The above results of medical emergency teams' activities indicate insufficient pharmacological treatment, which requires rapid improvement.