Disparities and determinants of outcomes in COVID-19 emergency department visits in the united states: a nationwide analysis of mortality and patient disposition

Abstract This study aimed to analyze patient outcomes in the emergency departments (EDs) during the peak of the pandemic in 2020, focusing on mortality and disposition, utilizing National Emergency Department Sample (NEDS) data. For this study, we included patients aged 18 and older who presented to the ED and were diagnosed with COVID-19, in 2020. Patient records were analyzed using SAS and Python softwares. Chi-squared tests and logistic regression models were utilized, with statistical significance set at p < 0.05. The study examined 2,863,207 COVID-19 patients out of 111,683,248 patient visits to the ED. There was a slight preponderance of females (52.6%) compared with males (47.4%), with the majority of patients being 50–69 years old (34%). Females exhibited significantly lower odds of mortality compared with males, with an OR of 0.7 ( p < 0.001). Those aged 70 and above ( p < 0.001), and Black individuals exhibited significantly higher odds of mortality in the ED ( p < 0.001). Our study aims to guide equitable interventions and resource allocation to optimize patient care and mitigate healthcare disparities, particularly by improving access through the ED and better preparing for the future, including other waves of COVID-19 infection with newer variants.