A comparison of emergency department presentations for medically unexplained symptoms in frequent attenders during COVID-19, 2021, Daniels et al

ABSTRACT
Medically unexplained symptoms (MUS) are those with no identified organic aetiology. Our emergency department (ED) perceived an increase in MUS frequency during COVID-19. The primary aim was to compare MUS incidence in frequent attenders (FAs) during COVID-19 and a control period.

A retrospective list of FA-MUS presenting to our ED from March to June 2019 (control) and March to June 2020 (during COVID-19) was compared. Fisher's exact test was used to compare binomial proportions; this presented as relative risk (RR) with 95% confidence intervals (95%CI).

During COVID-19, ED attendances reduced by 32.7%, with a significant increase in the incidence of FA-MUS and FA-MUS ED visits compared to control; RR 1.5 (95%CI 1.1–1.8) p=0.0006, and RR 1.8 (95%CI 1.6–2.0), p<0.0001, respectively.

Despite reduced ED attendances during COVID-19, there was a significant increase in the incidence of FA-MUS patients and corresponding ED visits by this cohort. This presents a challenge to ED clinicians who may feel underprepared to manage these patients effectively.

Open access, https://www.rcpjournals.org/content/clinmedicine/early/2021/05/20/clinmed.2020-1093

 

Well most of those would be Long Covid patients, or even acute Covid patients with less typical symptoms, which is rather self-evident to anyone paying attention.

To think that they invented a category for "things we don't understand yet" and instead use it to reassure themselves that there can't possibly be anything they don't understand yet is just institutional Dunning-Kruger.

 

Yes, and things like accident-related, violence-related and alcohol and (illicit) drug-related admissions are way down, so that leaves higher percentages for all remaining things.

NZ escaped lightly from Covid, with only six weeks of lockdown in total in my city, but it was a massive boon to the government's ACC (Accident Compensation Commission), whose incidence of major claims dropped to an unprecedented low during the lockdown period. So much for "Most accidents happen in the home". They may do, but a lot of the most serious ones happen elsewhere.

 

At least they mention they are using relative risks - researchers sometimes fudge whether they are using relative or absolute risk or numbers. It would have been nice to see what the absolute risks and numbers were as well as the relative numbers/percentages. So for example, using some completely made up numbers, let's pretend that there was an increase of 20% in frequent attenders with MUS compared to the previous year. But it would also be helpful to know that in 2019 the numbers were 1000 for FA-MUS and were 1200 in 2020.