Variations in Poisoning Epidemiology and Management During the Initial COVID-19 Outbreak in a Taiwanese Emergency Department.

PURPOSE

The COVID-19 pandemic significantly impacted the epidemiology of emergency department (ED) presentations, including those for self-harm and poisoning. Taiwan, with its strict border controls and quarantine measures, experienced a delayed COVID-19 outbreak in late April 2022. We evaluated epidemiological changes in ED poisoning cases and assessed whether their management was affected during the early stages of the COVID-19 outbreak.

PATIENTS AND METHODS

We conducted a retrospective cohort study of ED poisoning cases during the early phase of the COVID-19 outbreak (May 1-July 31, 2022) and the corresponding pre-COVID-19 periods (May 1-July 31, 2018, and 2019) at a tertiary medical center. Demographic data, poisoning characteristics, treatment efficiency, and clinical outcomes were compared between the two periods.

RESULTS

In total, 145 poisoning cases (48.3 per month) were identified during the pandemic, compared to 572 (95.3 per month) in the pre-pandemic period. Poisoned patients were significantly older (median age: 48 vs 40.5 years, p = 0.009) during the pandemic compared to the pre-pandemic periods, with a significant decline in pediatric poisoning cases. Although an increase in prescription drug exposures and a slight decrease in other poisoning categories was observed, these differences were not statistically significant. The proportion of severe poisoning cases (poisoning severity score 3 or 4) was significantly higher during the pandemic than in the pre-pandemic period (14.5% vs 7.9%, p = 0.021), and was accompanied by increased rates of intubation and intensive care unit admissions. ED stays were significantly prolonged during the pandemic, particularly among patients at risk of concurrent COVID-19 infection. Mortality rates remained comparable between the two periods.

CONCLUSION

The epidemiology, disease severity, and management efficiency of poisoning cases were significantly affected during the early phase of the nationwide COVID-19 outbreak. Further large-scale studies are needed to validate these findings and inform future interventions.