Chen Lu-Chen, Mao Chih-Yang, Cheong Chan-Wa, Chen Wei-Chen, Yen Tzung-Hai, Chen Hsien-Yi
Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan (R.O.C.).
Department of Nephrology and Clinical Poison Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Int J Gen Med. 2025 Jun 14;18:3175-3183. doi: 10.2147/IJGM.S520738. eCollection 2025.
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.
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.
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.
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.
新冠疫情对急诊科就诊的流行病学产生了重大影响，包括自残和中毒相关就诊情况。台湾由于实施严格的边境管控和检疫措施，于2022年4月下旬出现了延迟的新冠疫情爆发。我们评估了急诊科中毒病例的流行病学变化，并评估了在新冠疫情爆发早期其管理是否受到影响。
我们对一家三级医疗中心在新冠疫情爆发早期（2022年5月1日至7月31日）及相应的新冠疫情前时期（2018年和2019年5月1日至7月31日）的急诊科中毒病例进行了回顾性队列研究。比较了两个时期的人口统计学数据、中毒特征、治疗效率和临床结局。
疫情期间共识别出145例中毒病例（每月48.3例），而疫情前时期为572例（每月95.3例）。与疫情前时期相比，疫情期间中毒患者年龄显著更大（中位年龄：48岁对40.5岁，p = 0.009），儿童中毒病例显著减少。尽管观察到处方药暴露有所增加，其他中毒类别略有下降，但这些差异无统计学意义。疫情期间重度中毒病例（中毒严重程度评分3或4）的比例显著高于疫情前时期（14.5%对7.9%，p = 0.021），同时插管率和重症监护病房收治率增加。疫情期间急诊科留观时间显著延长，尤其是在有新冠病毒合并感染风险的患者中。两个时期的死亡率相当。
在全国范围内新冠疫情爆发的早期阶段，中毒病例的流行病学、疾病严重程度和管理效率受到了显著影响。需要进一步开展大规模研究来验证这些发现，并为未来的干预措施提供依据。
