• F Javier Montero-Pérez, Ángela María Cobos Requena, Juan González Del Castillo, Javier Jacob, Eric Jorge García-Lamberechts, Pascual Piñera Salmerón, Aitor Alquézar-Arbé, Sira Aguiló, Cesáreo Fernández Alonso, Guillermo Burillo-Putze, María Calderón Caro, Ángel Iván Díaz Salado, Enrique Martín Mojarro, Patricia Eiroa-Hernández, Patricia Parra-Esquivel, Juan José López Pérez, Ruiz GrinspanMartínMServicio de Urgencias, Hospital Universitario del Henares, Madrid, España., Ivet Gina Osorio Quispe, Matilde González Tejera, Leticia Serrano Lázaro, Begoña Espinosa Fernández, Lidia Fuentes, Coral Suero Méndez, María Del Valle Toro-Gallardo, Fahd Beddar Chaib, Paula Pedraza Ramírez, Òscar Miró, and Investigadores de la red SIESTA.
• Servicio de Urgencias, Hospital Universitario Reina Sofía, Córdoba, España.
• Emergencias. 2023 Aug 1; 35 (4): 270278270-278.

ObjectivesTo analyze the impact of the COVID-19 pandemic on Spanish emergency department (ED) care for patients aged 65 years or older during the first wave vs. a pre-pandemic period.Material And MethodsRetrospective cross-sectional study of a COVID-19 portion of the EDEN project (Emergency Department and Elder Needs). The EDEN-COVID cohort included all patients aged 65 years or more who were treated in 52 EDs on 7 consecutive days early in the pandemic. We analyzed care variables, discharge diagnoses, use of diagnostic and therapeutic resources, use of observation units, need for hospitalization, rehospitalization, and mortality. These data were compared with data for an EDEN cohort in the same age group recruited during a similar period the year before the pandemic.ResultsThe 52 participating hospital EDs attended 33 711 emergencies during the pandemic vs. 96 173 emergencies in the pre-COVID period, representing a 61.7% reduction during the pandemic. Patients aged 65 years or older accounted for 28.8% of the caseload during the COVID-19 period and 26.4% of the earlier cohort (P .001). The COVID-19 caseload included more men (51.0%). Comorbidity and polypharmacy were more prevalent in the pandemic cohort than in the earlier one (comorbidity, 92.6% vs. 91.6%; polypharmacy, 65.2% vs. 63.6%). More esturesources (analgesics, antibiotics, heparins, bronchodilators, and corticosteroids) were applied in the pandemic period, and common diagnoses were made less often. Observation wards were used more often (for 37.8% vs. 26.2% in the earlier period), and hospital admissions were more frequent (in 56.0% vs. 25.3% before the pandemic). Mortality was higher during the pandemic than in the earlier cohort either in ED (1.8% vs 0.5%) and during hospitalization (11.5 vs 2.9%).ConclusionThe proportion of patients aged 65 years or older decreased in the participating Spanish EDs. However, more resources were required and the pattern of diagnoses changed. Observation ward stays were longer, and admissions and mortality increased over the numbers seen in the reference period.

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