COVID-19 Impact on Australian Patients with Substance Use Disorders: Emergency Department Admissions in Western Sydney before Vaccine Roll Out

Meryem Jefferies; Harunor Rashid; Robert Graham; Scott Read; Gouri R Banik; Thao Lam; Gaitan F Njiomegnie; Mohammed Eslam; Xiaojing Zhao; Nausheen Ahmed; Mark W Douglas; Jacob George

doi:10.3390/vaccines10060889

COVID-19 Impact on Australian Patients with Substance Use Disorders: Emergency Department Admissions in Western Sydney before Vaccine Roll Out

Vaccines (Basel). 2022 Jun 1;10(6):889. doi: 10.3390/vaccines10060889.

Authors

Meryem Jefferies^{1

2}, Harunor Rashid^{3

4

5}, Robert Graham^{1

6}, Scott Read^{2

6

7}, Gouri R Banik^{4

5}, Thao Lam¹, Gaitan F Njiomegnie^{2

6}, Mohammed Eslam², Xiaojing Zhao¹, Nausheen Ahmed¹, Mark W Douglas^{2

4

8}, Jacob George²

Affiliations

¹ Western Sydney Local Health District Drug Health, North Parramatta, NSW 2151, Australia.
² Storr Liver Centre, The Westmead Institute for Medical Research, The University of Sydney and Westmead Hospital, Westmead, NSW 2145, Australia.
³ National Centre for Immunisation Research and Surveillance (NCIRS), The Children's Hospital at Westmead, Westmead, NSW 2145, Australia.
⁴ Sydney Institute for Infectious Diseases, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia.
⁵ The Children's Hospital at Westmead Clinical School, the Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia.
⁶ Blacktown/Mt Druitt Clinical School and Research Centre, School of Medicine, Western Sydney University, Blacktown, NSW 2148, Australia.
⁷ Blacktown Hospital, Western Sydney Local Health District, Blacktown, NSW 2148, Australia.
⁸ Centre for Infectious Diseases and Microbiology, Westmead Hospital, Westmead, NSW 2145, Australia.

Abstract

Background: In this study, we determined the impact of the COVID-19 pandemic on Western Sydney patients with substance use disorders (SUD) by comparing emergency department (ED) admission rates before and after the onset of the COVID-19 pandemic and before the rollout of COVID-19 vaccination. Methods: ED admission data for patients with SUD were retrieved from the local electronic medical record (eMR) on the hospital central database. ED data collected from 25 January to 25 July 2019 (before the COVID-19 pandemic) were compared with data from 25 January to 25 July 2020 (early pandemic). ED admission reasons were categorised based on the presenting complaints and ED diagnoses. Results: Despite an overall reduction in ED admissions during the early pandemic, compared to the pre-pandemic period, admissions for patients with SUD increased significantly (1.7% to 3.4%, p < 0.01). ED admission rates related to infection (0.05% to 0.12%, p < 0.01), local infection (0.02% to 0.05%, p < 0.01), trauma (0.06% to 0.12%, p < 0.01), alcohol (0.01% to 0.03%, p < 0.05), and other issues (0.06% to 0.10%, p < 0.05) increased significantly among Indigenous patients with SUD. ED admission rates related to drugs (0.12% to 0.39%, p < 0.01), infection (0.21% to 0.34%, p < 0.01), local infection (0.07% to 0.18%, p < 0.01), gastrointestinal (0.15% to 0.23%, p < 0.05), trauma (0.14% to 0.25%, p < 0.01), alcohol (0.36% to 0.74%, p < 0.01), and ‘other’ issues (0.47% to 0.91%, p < 0.01) increased significantly among non-Indigenous patients with SUD. Four cases of COVID-19 were reported among these patients. Conclusions: There was an increase in ED admissions for patients with SUD in the initial six months of the COVID-19 pandemic (before vaccine rollout), mainly for drugs, systemic infection, local infection, trauma, and alcohol-related reasons. Now that most people in New South Wales have been vaccinated against COVID-19, a further study is needed to quantify the effect of the pandemic on patients with SUD in the post-vaccine era.

Keywords: COVID-19 impact; addiction; alcohol dependence; drug health patient; substance use disorder.

Grants and funding

This study received in-kind support from Western Sydney Local Health District Drug Health.