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Lessons from COVID-19 syndromic surveillance through emergency department activity: a prospective time series study from western Switzerland.
Ageron, Francois-Xavier; Hugli, Olivier; Dami, Fabrice; Caillet-Bois, David; Pittet, Valerie; Eckert, Philippe; Beysard, Nicolas; Carron, Pierre-Nicolas.
  • Ageron FX; Emergency Department, Lausanne University Hospital, Lausanne, Switzerland francois-xavier.ageron@chuv.ch.
  • Hugli O; Emergency Department, Lausanne University Hospital, Lausanne, Switzerland.
  • Dami F; Emergency Department, Lausanne University Hospital, Lausanne, Switzerland.
  • Caillet-Bois D; Emergency Department, Lausanne University Hospital, Lausanne, Switzerland.
  • Pittet V; Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
  • Eckert P; General Directorate, Lausanne University Hospital, Lausanne, Switzerland.
  • Beysard N; Emergency Department, Lausanne University Hospital, Lausanne, Switzerland.
  • Carron PN; Emergency Department, Lausanne University Hospital, Lausanne, Switzerland.
BMJ Open ; 12(5): e054504, 2022 05 06.
Article in English | MEDLINE | ID: covidwho-1832443
ABSTRACT

OBJECTIVE:

We aimed to assess if emergency department (ED) syndromic surveillance during the first and second waves of the COVID-19 outbreak could have improved our surveillance system. DESIGN AND SETTINGS We did an observational study using aggregated data from the ED of a university hospital and public health authorities in western Switzerland.

PARTICIPANTS:

All patients admitted to the ED were included. PRIMARY OUTCOME

MEASURE:

The main outcome was intensive care unit (ICU) occupancy. We used time series methods for ED syndromic surveillance (influenza-like syndrome, droplet isolation) and usual indicators from public health authorities (new cases, proportion of positive tests in the population).

RESULTS:

Based on 37 319 ED visits during the COVID-19 outbreak, 1421 ED visits (3.8%) were positive for SARS-CoV-2. Patients with influenza-like syndrome or droplet isolation in the ED showed a similar correlation to ICU occupancy as confirmed cases in the general population, with a time lag of approximately 13 days (0.73, 95% CI 0.64 to 0.80; 0.79, 95% CI 0.71 to 0.86; and 0.76, 95% CI 0.67 to 0.83, respectively). The proportion of positive tests in the population showed the best correlation with ICU occupancy (0.95, 95% CI 0.85 to 0.96).

CONCLUSION:

ED syndromic surveillance is an effective tool to detect and monitor a COVID-19 outbreak and to predict hospital resource needs. It would have allowed to anticipate ICU occupancy by 13 days, including significant aberration detection at the beginning of the second wave.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Influenza, Human / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-054504

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Influenza, Human / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2022 Document Type: Article Affiliation country: Bmjopen-2021-054504