Emergency Department Surveillance of Self-Reported Covid-19.

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.