ED COVID-19 Registry
We propose a national ED COVID-19 registry to address critical knowledge gaps in emergency care and operations. We will do this by prospectively and retrospectively gathering data on COVID-19 patients seen in EDs across Canada, and will follow patients by telephone after discharge from hospital to ask standard quality of life questions and determine long-term outcomes.
Our vision is to create a robust national ED dataset to answer multiple emerging research questions and inform early acute care decisions that are currently being made with minimal evidence to inform them.
While critical care and acute medicine groups may have plans to create a registry of hospitalized patients using International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC)-WHO case report forms,4 these lack ED data elements that are important to inform early decision-making in EDs. Such variables may help us, for example, identify who should or should not be intubated in the ED.
In addition, the ISARIC-WHO forms lack information about vulnerable populations commonly discharged from the ED. These include the homeless and those suffering from mental health and substance use disorders.
Lastly, datasets on hospitalized patients do not contain data on the majority of patients with suspected COVID-19 who are discharged from EDs. Based on Chinese and European unpublished data these constitute roughly 80% of all patients evaluated in EDs for COVID-19.
Thus, our proposed ED registry not only has the potential to address critical questions related to ED decision-making for the 20% of patients who are admitted to hospital but will also allow us to address research questions to optimize care and decision-making for the 80% we will discharge, including vulnerable populations.