Emergency Department Surveillance of Self-Reported Covid-19.

Publication date: Jul 01, 2025

The COVID-19 pandemic is a dynamic public health issue that requires up-to-date surveillance data to guide healthcare and public policy interventions. We sought to address gaps in COVID-19 surveillance data of underserved populations by assessing self-reported COVID-19 positivity rates in a national sample of patients in emergency departments (EDs). We used data from two cross-sectional survey studies of adult patients presenting to 19 U. S. EDs during two periods: Period 1 (December 2020-March 2021) and Period 2 (December 2022-December 2023). In Period 1(n = 2101), 333 (15. 8%) reported having had a positive COVID-19 test. Positivity rates were significantly higher in Hispanic vs. White (non-Hispanic) participants (21. 7% vs. 14. 3%; difference 7. 4%, 95% CI [3. 2-11. 8%]) and non-English vs. English speakers (21. 5% vs. 14. 5%; difference 7. 0%, 95% CI [2. 9-11. 5%]). In Period 2 (n = 3658), 1674 (45. 8%) reported having had a positive COVID-19 test. Positivity rates were significantly higher in women vs. men (50. 3% vs. 40. 6%, difference 9. 6%, 95% CI [6. 4-12. 8%]); White (non-Hispanic) vs. African American (non-Hispanic) participants (47. 9% vs. 39. 1%; difference 8. 8%, 95% CI [4. 8-12. 8%]); Hispanic vs. White (non-Hispanic) participants (52. 8% vs. 47. 9%; difference 4. 9%, 95% CI [0. 5-9. 3%]); and non-English vs. English speakers (49. 3% vs. 45. 0%; difference 4. 2%, 95% CI [0. 05-8. 4%]). We found that Hispanics had higher rates of prior positive COVID-19 tests that persisted throughout the pandemic. In the later pandemic period, women had significantly higher rates of prior positive COVID-19 tests than men.

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