The Rescue of the Romanian Health System by the Emergency Departments during the Fourth Wave of COVID-19 Pandemic

SIMPLE SUMMARY: The COVID-19 pandemic represents a public health problem that imposes a series of epidemiological measures with an important impact on the health system. Up to now, humanity has faced six waves of this pandemic, in each of which a certain strain of SARS-CoV-2 was dominant. In the fourth wave of the pandemic, the most presentations were recorded in emergency departments, which led to a need for special measures to allow the provision of medical care to as many patients as possible. We conducted a retrospective, observational study on a group of 1417 patients who presented themselves and received medical care at the Emergency Department of the Clinical Emergency Hospital of Bucharest, Romania, during the fourth wave of the COVID-19 pandemic. The average age of the patients included in our study (60 years) was higher than the average age reported for infection with the Omicron strains. Additionally, the severity of the cases was significant, with a rate of orotracheal intubation and mechanical ventilation of approximately 10%. In the condition of full occupancy of the hospital beds on the wards, all the necessary therapeutic measures for these patients were given in the emergency department by a multidisciplinary team. ABSTRACT: The COVID-19 pandemic has led to the confrontation of the health system with the need to identify solutions for providing medical care to a very large number of patients. The main objective of our study was to describe the measures taken to provide optimal medical care to patients who presented themselves in one of the large emergency hospitals of Romania in the fourth wave of the COVID-19 pandemic. Material and Methods: We conducted a retrospective, observational study on a group of 1417 patients. The statistical analysis was performed using R. Results: The average length of stay of patients in the emergency departments was approximately 2.6 h, increasing to up to 15 days in some more severe cases. For rapid antigen tests, the highest positivity rate for SARS-CoV-2 was identified in patients aged >75 years (53%). Among the identified risk factors associated with the need for mechanical ventilation were advanced age (α < 0.001) and lack of vaccination against SARS-CoV-2 (α < 0.001). Discussion and conclusions: A method of saving the Romanian health system in full hospital bed occupancy conditions in the wards proved to be the provision of medical care in emergency departments.