Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study
Abstract
:1. Introduction
2. Methods
2.1. Design
2.2. Patients and Data
2.3. Objectives
2.4. Ethics
2.5. Data Analysis
3. Results
3.1. Demographic Description
3.2. COVID-19 Symptoms and Possible Mode of Contamination
3.3. Vital Parameters and Clinical Examination at ED Arrival
3.4. Tests Performed at ED Arrival
3.5. ED Therapeutic Management
3.6. Patient Outcomes after ED Management
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
C+ Group | C− Group | |
---|---|---|
Mean age in years +/− SD | 0 | 5 |
Sex | 1 | 1 |
Current pregnancy (less 40yo) | 0 | 0 |
Healthcare worker | 5 | 0 |
Institutional living | 2 | 0 |
Contact COVID-19 | 297 | 71 |
Diabetes mellitus all types | 42 | 202 |
Arterial hypertension | 27 | 2 |
Chronic heart failure | 8 | 3 |
Coronary artery disease | 8 | 3 |
Chronic obstructive pulmonary disease | 5 | 0 |
Asthma | 4 | 1 |
History of stroke | 6 | 0 |
Active malignant neoplasm | 4 | 0 |
Chronic respiratory insufficiency | 7 | 0 |
Chronic kidney disease | 8 | 1 |
With chronic hemodialysis | 0 | 0 |
Chronic liver disease | 7 | 0 |
Factor of immunosuppression | 28 | 212 |
Current smoking | 219 | 795 |
Alcohol chronic consumption | 151 | 863 |
Overweight/obesity | 124 | 1070 |
Body mass index | 165 | 76 |
Treatment | ||
Angiotensin-converting enzyme inhibitors | 78 | 4 |
Angiotensin II receptor blockers | 76 | 3 |
Nonsteroidal anti-inflammatory | 15 | 7 |
C+ Group | C− Group | |
---|---|---|
Mean duration of symptoms in days | 62 | 451 |
Self-reported feverishness | 3 | 4 |
Cough | 20 | 169 |
Sputum production | 14 | 21 |
Sore throat | 76 | 543 |
Runny nose | 10 | 20 |
Shortness of breath | 4 | 3 |
Chest pain | 6 | 8 |
Muscle aches | 73 | 520 |
Abdominal pain | 71 | 609 |
Diarrhea | 52 | 480 |
Vomiting/nausea | 6 | 2 |
Headache | 10 | 16 |
Altered consciousness/confusion | 11 | 4 |
Ageusia | 101 | 726 |
Anosmia | 19 | 22 |
Agnosia | 16 | 22 |
Skin rash | 15 | 2 |
C+ Group | C− Group | |
---|---|---|
Temperature | 16 | 238 |
Over 38.5 | 16 | 238 |
Heart rate | 30 | 374 |
Tachycardia | 30 | 374 |
Respiratory rate | 214 | 1581 |
Over 20/min | 214 | 1581 |
Systolic blood pressure | 43 | 453 |
Diastolic blood pressure | 44 | 454 |
Mental status | 194 | 1337 |
Pulmonary auscultation | 20 | 85 |
Swinging thoracoabdominal | 20 | 8 |
Supraclavicular pulling | 24 | 9 |
Subcostal pulling | 25 | 9 |
References
- Li, Q.; Guan, X.; Wu, P.; Wang, X.; Zhou, L.; Tong, Y.; Ren, R.; Leung, K.S.M.; Lau, E.H.Y.; Wong, J.Y.; et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. N. Engl. J. Med. 2020, 382, 1199–1207. [Google Scholar] [CrossRef] [PubMed]
- Maxmen, A. How much is coronavirus spreading under the radar? Nature 2020. online ahead of print. [Google Scholar] [CrossRef] [PubMed]
- Lipsitch, M.; Swerdlow, D.L.; Finelli, L. Defining the epidemiology of COVID-19—Studies needed. N. Engl. J. Med. 2020, 382, 1194–1196. [Google Scholar] [CrossRef] [PubMed]
- Coronavirus (COVID-19) Events as They Happen. Available online: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen (accessed on 3 February 2021).
- Yordanov, Y.; Dechartres, A.; Lescure, X.; Apra, C.; Villie, P.; Marchand-Arvier, J.; Debuc, E.; Dinh, A.; Jourdain, P. Covidom, a telesurveillance solution for home monitoring patients with COVID-19. J. Med. Internet Res. 2020, 22, e20748. [Google Scholar] [CrossRef]
- Huang, C.; Wang, Y.; Li, X.; Huang, C.; Wang, Y.; Li, X.; Ren, L.; Zhao, J.; Hu, Y.; Zhang, L.; et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020, 395, 497–506. [Google Scholar] [CrossRef] [Green Version]
- Deng, Y.; Liu, W.; Liu, K.; Fang, Y.-Y.; Shang, J.; Zhou, L.; Wang, K.; Leng, F.; Wei, S.; Chen, L.; et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: A retrospective study. Chin. Med. J. 2020, 133, 1261–1267. [Google Scholar] [CrossRef]
- Chen, T.; Wu, D.; Chen, H.; Yan, W.; Yang, D.; Chen, G.; Ma, K.; Xu, D.; Yu, H.; Wang, H.; et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ 2020, 368, m1091. [Google Scholar] [CrossRef] [Green Version]
- Wang, Y.; Lu, X.; Li, Y.; Chen, H.; Chen, T.; Su, N.; Huang, F.; Zhou, J.; Zhang, B.; Yan, F.; et al. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am. J. Respir. Crit. Care Med. 2020, 201, 1430–1434. [Google Scholar] [CrossRef] [Green Version]
- Zhou, F.; Yu, T.; Du, R.; Fan, G.; Liu, Y.; Liu, Z.; Xiang, J.; Wang, Y.; Song, B.; Gu, X.; et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020, 395, 1054–1062. [Google Scholar] [CrossRef]
- Wu, C.; Chen, X.; Cai, Y.; Xia, J.; Zhou, X.; Xu, S.; Huang, H.; Zhang, L.; Zhou, X.; Du, C.; et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern. Med. 2020, 180, 934–943. [Google Scholar] [CrossRef]
- Du, R.-H.; Liang, L.-R.; Yang, C.-Q.; Wang, W.; Cao, T.-Z.; Li, M.; Guo, G.-Y.; Du, J.; Zheng, C.-L.; Zhu, Q.; et al. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: A prospective cohort study. Eur. Respir. J. 2020, 55, 2000524. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chen, R.; Liang, W.; Jiang, M.; Guan, W.; Zhan, C.; Wang, T.; Tang, C.; Sang, L.; Liu, J.; Ni, Z.; et al. Risk factors of fatal outcome in hospitalized subjects with coronavirus disease 2019 from a nationwide analysis in China. Chest 2020, 158, 97–105. [Google Scholar] [CrossRef] [PubMed]
- Rodriguez-Morales, A.J.; Cardona-Ospina, J.A.; Gutiérrez-Ocampo, E.; Villamizar-Peña, R.; Holguin-Rivera, Y.; Escalera-Antezana, J.P.; Alvarado-Arnez, L.E.; Bonilla-Aldana, D.K.; Franco-Paredes, C.; Henao-Martinez, A.F.; et al. Clinical, laboratory and imaging features of COVID-19: A systematic review and meta-analysis. Travel Med. Infect. Dis. 2020, 10, 1623. [Google Scholar] [CrossRef]
- Cao, Y.; Li, Q.; Chen, J.; Guo, X.; Miao, C.; Yang, H.; Chen, Z.; Li, C.; Li, L. Hospital emergency management plan during the COVID-19 epidemic. Acad. Emerg. Med. 2020, 27, 309–311. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wang, W.; Xu, Y.; Gao, R.; Lu, R.; Han, K.; Wu, G.; Tan, W. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 2020. online ahead of print. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zhao, W.; Zhong, Z.; Xie, X.; Yu, Q.; Liu, J. Relation between chest CT findings and clinical conditions of Coronavirus Disease (COVID-19) pneumonia: A multicenter study. AJR Am. J. Roentgenol. 2020, 214, 1287–1294. [Google Scholar] [CrossRef]
- Ai, T.; Yang, Z.; Hou, H.; Zhan, C.; Chen, C.; Lv, W.; Tao, Q.; Sun, Z.; Xia, L. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases. Radiology 2020, 25, 200642. [Google Scholar] [CrossRef] [Green Version]
- Rubin, G.D.; Ryerson, C.J.; Haramati, L.B.; Sverzellati, N.; Kanne, J.P.; Raoof, S.; Schluger, N.W.; Volpi, A.; Yim, J.-J.; Martin, I.B.; et al. The role of the chest imaging in patient management during the COVID-19 pandemic: A multinational consensus statement from the Fleischner Society. Chest 2020, 158, 106–116. [Google Scholar] [CrossRef]
- De Smet, K.; De Smet, D.; Ryckaert, T.; Laridon, E.; Heremans, B.; Vandenbulcke, R.; Demedts, I.; Bouckaert, B.; Gryspeerdt, S.; Martens, G.A. Diagnostic Performance of Chest CT for SARS-CoV-2 Infection in Individuals with or without COVID-19 Symptoms. Radiology 2021, 298, E30–E37. [Google Scholar] [CrossRef]
- Lauer, S.A.; Grantz, K.H.; Bi, Q.; Jones, F.K.; Zheng, Q.; Meredith, H.R.; Azman, A.S.; Reich, N.G.; Lessler, J. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Ann. Intern. Med. 2020, 172, 577–582. [Google Scholar] [CrossRef]
- Sullivan, S.G.; Carlson, S.; Cheng, A.C.; Chilver, M.B.; E Dwyer, D.; Irwin, M.; Kok, J.; Macartney, K.; MacLachlan, J.; Minney-Smith, C.; et al. Where has all the influenza gone? The impact of COVID-19 on the circulation of influenza and other respiratory viruses, Australia, March to September 2020. Euro Surveill. 2020, 25, 2001847. [Google Scholar] [CrossRef] [PubMed]
- Peyrony, O.; Marbeuf-Gueye, C.; Truong, V.; Giroud, M.; Rivière, C.; Khenissi, K.; Legay, L.; Simonetta, M.; Elezi, A.; Principe, A.; et al. Accuracy of emergency department clinical findings for diagnosis of coronavirus disease 2019. Ann. Emerg. Med. 2020, 76, 405–412. [Google Scholar] [CrossRef] [PubMed]
- Hu, Y.; Zhan, C.; Chen, C.; Ai, T.; Xia, L. Chest CT findings related to mortality of patients with COVID-19: A retrospective case-series study. PLoS ONE 2020, 15, e0237302. [Google Scholar] [CrossRef] [PubMed]
- Charpentier, E.; Soulat, G.; Fayol, A.; Hernigou, A.; Livrozet, M.; Grand, T.; Reverdito, G.; al Haddad, J.; Tran, K.D.D.; Charpentier, A.; et al. Visual lung damage CT score at hospital admission of COVID-19 patients and 30-day mortality. Eur. Radiol. 2021, 31, 8354–8363. [Google Scholar] [CrossRef] [PubMed]
- Freund, Y.; Drogrey, M.; Miró; Marra, A.; Féral-Pierssens, A.; Pd, A.P.; Hernandez, B.A.L.; Beaune, S.; Gorlicki, J.; Ayar, P.V.; et al. Association between pulmonary embolism and COVID-19 in emergency department patients undergoing computed tomography pulmonary angiogram: The PEPCOV international retrospective study. Acad. Emerg. Med. 2020, 27, 811–820. [Google Scholar] [CrossRef]
- Akl, E.A.; Blažić, I.; Yaacoub, S.; Frija, G.; Chou, R.; Appiah, J.A.; Fatehi, M.; Flor, N.; Hitti, E.; Jafri, H.; et al. Use of chest imaging in the diagnosis and management of COVID-19: A WHO rapid advice guide. Radiology 2021, 298, E63–E69. [Google Scholar] [CrossRef]
- Desmet, J.; Biebaû, C.; De Wever, W.; Cockmartin, L.; Viktor, V.; Coolen, J.; Verschakelen, J.; Dubbeldam, A. Performance of low-dose chest CT as a triage tool for suspected COVID-19 patients. J. Belg. Soc. Radiol. 2021, 105, 9. [Google Scholar] [CrossRef]
- Sun, X.; Wang, T.; Cai, D.; Hu, Z.; Chen, J.; Liao, H.; Zhi, L.; Wei, H.; Zhang, Z.; Qiu, Y.; et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine Growth Factor Rev. 2020, 53, 38–42. [Google Scholar] [CrossRef]
- Douillet, D.; Penaloza, A.; Mahieu, R.; Morin, F.; Chauvin, A.; Gennai, S.; Schotte, T.; Montassier, E.; Thiebaud, P.-C.; François, A.G.; et al. Outpatient management of patients with COVID-19: Multicenter prospective validation of the hospitalization or outpatient management of patients with SARS-CoV-2 infection rule to discharge patients safely. Chest 2021, 160, 1222–1231. [Google Scholar] [CrossRef]
- Pettit, N.N.; Nguyen, C.T.; Lew, A.K.; Bhagat, P.H.; Nelson, A.; Olson, G.; Ridgway, J.P.; Pho, M.T.; Pagkas-Bather, J. Reducing the use of empiric antibiotic therapy in COVID-19 on hospital admission. BMC Infect. Dis. 2021, 21, 516. [Google Scholar] [CrossRef]
- Molina, J.; Delaugerre, C.; Le Goff, J.; Mela-Lima, B.; Ponscarme, D.; Goldwirt, L.; de Castro, N. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Med. Mal. Infect. 2020, 50, 384. [Google Scholar] [CrossRef] [PubMed]
- Zucman, N.; Mullaert, J.; Roux, D.; Roca, O.; Ricard, J.-D.; Longrois, D.; Dreyfuss, D. Prediction of outcome of nasal high flow use during COVID-19-related acute hypoxemic respiratory failure. Intensive Care Med. 2020, 46, 1924–1926. [Google Scholar] [CrossRef] [PubMed]
C+ Group (n = 1764) | C− Group (n = 5668) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
RT-PCR | Chest CT Scan | RT-PCR | Chest CT Scan | |||||||
Total C+ n (%) | Performed n (% | Positive n (%) | Performed n (%) | In Favor n (%) | Performed n (%) | Positive n (%) | Performed n (%) | In Favor n (%) | Total C− n (%) | |
TOTAL | 1764 (23.7) | 1645 (93.3) | 1359 (82.6) | 1192 (67.6) | 1120 (63.5) | 4262 (75.2) | 0 (0) | 1406 (24.8) | 0 (0) | 5668 (76.3) |
C+ Group (n = 1764) | C− Group (n = 5668) | p-Value | OR CI 95% | |
---|---|---|---|---|
Demographic data, n (%) | ||||
Mean age in years +/− SD | 63.8 +/− 17.5 | 51.8 +/− 21.1 | <0.01 | 1.86 [1.44; 2.28] |
Male | 993 (54.6) | 2615 (46.1) | <0.01 | 1.51 [1.36; 1.68] |
Current Pregnancy (less 40 yo) | 13/96 (13.5) | 51/1176 (4.3) | <0.01 | 3.45 [1.80; 6.60] |
Medical History, n (%) | ||||
Diabetes mellitus all types | 373 (21.7) | 642 (11.7) | <0.01 | 2.08 [1.81; 2.40] |
Arterial hypertension | 755 (43.5) | 1287 (22.7) | <0.01 | 2.62 [2.34; 2.93] |
Overweight or obesity | 287 (17.5) | 515 (23.2) | <0.01 | 1.68 [1.44; 1.97] |
Chronic heart failure | 229 (13.0) | 520 (9.2) | <0.01 | 1.48 [1.25; 1.75] |
Coronary artery disease | 204 (11.6) | 401 (7.1) | <0.01 | 1.73 [1.45; 2.07] |
Chronic obstructive pulmonary disease | 155 (8.8) | 408 (7.2) | <0.01 | 1.25 [1.03; 1.52] |
Asthma | 152 (8.6) | 641 (11.3) | <0.01 | 0.74 [0.61; 0.89] |
History of Stroke | 131 (7.5) | 232 (4.1) | <0.01 | 1.88 [1.51; 2.35] |
Active malignant neoplasm | 102 (5.8) | 317 (5.6) | 0.02 | 1.04 [0.83; 1.31] |
Chronic kidney disease | 108 (2.3) | 235 (4.1) | <0.01 | 1.51 [1.19; 1.91] |
Chronic liver disease | 32 (1.8) | 73 (1.3) | 0.17 | 1.42 [0.93; 2.16] |
Factor of immunosuppression | 100 (5.8) | 370 (6.8) | 0.21 | 0.84 [0.67; 1.05] |
Habitus, n (%) | ||||
Current smoking | 173 (11.2) | 1033 (21.2) | <0.01 | 0.47 [0.40; 0.56] |
Alcohol chronic consumption (confirmed or suspected) | 68 (4.2) | 311 (6.5) | 0.04 | 0.64 [0.49; 0.84] |
Chronic treatment, n (%) | ||||
Angiotensin converting enzyme inhibitors | 250 (16.5) | 429 (7.6) | <0.01 | 2.12 [1.79; 2.50] |
Angiotensin II receptor blockers | 179 (10.6) | 288 (5.1) | <0.01 | 2.21 [1.82; 2.69] |
Non-steroidal anti-inflammatory | 147 (9.1) | 373 (6.6) | 0.01 | 1.30 [1.07; 1.59] |
C+ Group (n = 1764) | C− Group (n = 5668) | p-Value | OR CI 95% | |
---|---|---|---|---|
Mean duration of symptoms +/− SD (in days) | 6.6 +/− 4.7 | 5.4 +/− 5.6 | <0.01 | 1.17 [1.08; 1.26] |
Possible mode of contamination, n (%) | ||||
Healthcare worker | 85 (4.8) | 260 (4.6) | <0.01 | 1.06 [0.82; 1.36] |
Institutional living | 161 (9.1) | 314 (5.5) | <0.01 | 1.65 [1.35; 2.01] |
Notion of COVID-19 contact | 470 (32.0) | 674 (12.0) | <0.01 | 3.44 [3.0; 3.44] |
Symptoms, n (%) | ||||
Self-reported feverishness | 1214 (68.9) | 2335 (41.2) | <0.01 | 3.15 [2.81; 3.53] |
Cough | 1175 (67.4) | 3378 (61.4) | <0.01 | 1.30 [1.16; 1.46] |
Shortness breath | 973 (55.3) | 2490 (44.0) | <0.01 | 1.58 [1.42; 1.76] |
Muscle aches | 386 (22.8) | 1198 (23.3) | 0.69 | 0.98 [0.86; 1.12] |
Diarrhea | 363 (21.2) | 923 (17.8) | <0.01 | 1.24 [1.08; 1.42] |
Headache | 273 (15.6) | 864 (15.3) | 0.79 | 1.02 [0.88; 1.18] |
Chest pain | 248 (14.1) | 1383 (24.4) | <0.01 | 0.51 [0.44; 0.59] |
Sputum production | 215 (12.3) | 626 (11.1) | 0.17 | 1.12 [0.95; 1.32] |
Ageusia | 190 (11.4) | 242 (4.9) | <0.01 | 2.51 [2.06; 3.06] |
Vomiting Nausea | 180 (10.2) | 563 (9.9) | 0.72 | 1.03 [0.86; 1.23] |
Abdominal pain | 152 (9.0) | 448 (8.9) | 0.89 | 1.02 [0.84; 1.24] |
Sore throat | 148 (8.8) | 630 (12.3) | <0.01 | 0.69 [0.57; 0.83] |
Anosmia | 153 (8.8) | 163 (2.9) | <0.01 | 3.23 [2.57; 4.06] |
Altered consciousness confusion | 153 (8.7) | 307 (5.4) | <0.01 | 1.67 [1.36; 2.04] |
Runny nose | 124 (7.1) | 531 (9.4) | <0.01 | 0.73 [0.60; 0.89] |
Agnosia | 24 (1.4) | 19 (0.3) | <0.01 | 4.03 [2.20; 7.37] |
Skin rash | 10 (0.6) | 35 (0.6) | 0.83 | 0.93 [0.46; 1.88] |
C+ Group (n = 1764) | C− Group (n = 5668) | p-Value | OR CI 95% | |
---|---|---|---|---|
Vital parameter at admission | ||||
Temperature (in Celsius degree) | 37.5 +/− 2.6 | 37.1 +/− 2.8 | 0.3 | 0.94 [0.86; 1.02] |
Over 38.5 °C | 303 (17.3) | 427 (7.8) | <0.01 | |
Mean heart rate +/− SD | 90 +/− 23 | 91 +/− 24 | 0.22 | 1.07 [0.93; 1.21] |
Tachycardia (more than 90/min) | 821 (47.3) | 2602 (49.1) | 0.19 | 0.93 [0.83; 1.04] |
Mean respiratory rate +/− SD * | 23 +/− 7 | 21 +/− 6 | <0.01 | |
Over 30 cycles/min * | 267 (17.3) | 431 (10.5) | <0.01 | |
Mean systolic blood pressure | 133 +/− 35 | 137 +/− 37 | <0.01 | 0.94 [0.89; 0.99] |
Mean diastolic blood pressure | 75 +/− 21 | 79 +/− 22 | <0.01 | 0.83 [0.78; 0.88] |
TAS < 90 mmHg | 16 (0.9) | 56 (1.1) | ||
Oxygen saturation in room air | 94 +/− 2 (n = 1392) | 97 +/− 3 (n = 4888) | <0.01 | 0.83 [0.77; 0.89] |
Oxygen saturation < 90% | 248 (17.8) | 162 (3.3) | <0.01 | |
Mental Status * | ||||
GCS 14/15 | 1506 (95.9) | 4242 (97.9) | ||
GCS 9/13 | 53 (3.3) | 68 (1.6) | ||
GCS < 9 | 11 (0.8) | 21 (0.5) | ||
Clinical examination at admission | ||||
Pulmonary auscultation | ||||
Crackles | 998 (57.2) | 854 (15.3) | <0.01 | 7.35 [6.52; 8.27] |
Normal | 669 (38.4) | 4341 (77.7) | <0.01 | 0.19 [0.17; 0.21] |
Other | 77 (4.4) | 388 (6.9) | <0.01 | 0.62 [0.48; 0.80] |
Signs of respiratory struggle | ||||
Swinging thoracoabdominal | 116 (6.7) | 131 (2.3) | <0.01 | 3.01 [2.33; 3.89] |
Supra-clavicular pulling | 150 (8.6) | 195 (3.4) | <0.01 | 2.64 [2.12; 3.29] |
Subcostal pulling | 101 (5.8) | 98 (1.7) | <0.01 | 3.50 [2.64; 4.65] |
C+ Group (n = 1764) | C− Group (n = 5668) | p-Value | OR CI 95% | |
---|---|---|---|---|
Radiological exam n (%) | ||||
Chest radiography | 593 (33.7) | 2013 (35.5) | 0.14 | 0.92 [0.82; 1.03] |
Infiltrate | 391 (65.9) | 518 (25.7) | <0.01 | 5.59 [4.59; 6.81] |
Pleural effusion | 48 (8.0) | 816 (40.5) | <0.01 | 0.13 [0.10; 0.18] |
Normal | 98 (16.4) | 770 (38.3) | <0.01 | 0.32 [0.25; 0.40] |
Biological test (mean +/− SD) | ||||
Haemoglobin (g/L) | 13.4 +/− 1.2 | 13.3 +/−1.5 | 0.8 | 0.95 [0.85; 1.05] |
White blood count (G/L) | 8.6 +/− 9.3 | 10.2 +/− 8.4 | <0.01 | 0.78 [0.66; 0.90] |
Haematocrit (%) | 39.8 +/− 6.3 | 40 +/− 6.2 | 0.31 | 0.89 [0.69; 1.09] |
Platelets (G/L) | 218 +/− 95.4 | 254 +/− 93.8 | <0.01 | 0.92 [0.78; 1.06] |
Urea (mmol/L) | 7.8 +/− 5.5 | 6.5 +/− 4.5 | <0.01 | 1.28 [1.14; 1.42] |
Creatinine (μmol/L) | 73.4 +/− 59.2 | 82.6 +/− 52.4 | <0.01 | 0.83 [0.69; 0.97] |
Lactate (mmol/L) | 1.3 +/− 0.83 | 0.9 +/− 1 | <0.01 | 1.22 [1.14; 1.32] |
Procalcitonin (ng/mL) | 0.91 +/− 2.6 | 0.63 +/− 1.9 | 0.09 | |
PCT > 1, n (%) | 34 (13.9) | 60 (10.1) | 0.12 | |
CRP (mg/L) | 86.2 +/− 80.4 | 45.4 +/− 70.4 | <0.01 | 1.86 [1.56; 2.16] |
LDH (U/L) | 308 +/− 139 | 253 +/− 99 | <0.01 | 1.65 [1.44; 1.86] |
D-dimer (μg/L) | 1072 +/− 1057 | 756 +/− 968 | <0.01 | 1.47 [1.17; 1.77] |
Ferritin (ng/mL) | 544 +/− 278 | 263 +/− 259 | <0.01 | 1.95 [1.67; 2.23] |
C+ Group (n = 1764) n (%) | C− Group (n = 5668) n (%) | p-Value | OR IC 95% | |
---|---|---|---|---|
Oxygen therapy in ED | N = 998 | N = 877 | <0.01 | 7.12 [6.32; 8.02] |
02 flow | 813 (81.4) | 779 (88.8) | ||
1–5 L | 535 (65.8) | 644 (82.7) | ||
6–10 L | 154 (18.9) | 93 (11.9) | ||
11–15 L | 73 (9.0) | 17 (2.2) | ||
>15 L | 51 (6.3) | 25 (3.2) | ||
Non-invasive ventilation | 142 (14.2) | 47 (5.4) | <0.01 | 10.47 [7.49; 14.63] |
Invasive ventilation | 43 (4.4) | 51 (5.8) | <0.01 | 2.75 [1.83; 4.14] |
Inotropes vasopressors | 21 (1.2) | 10 (0.2) | <0.01 | 6.82 [3.21; 14.51] |
Antivirals | 39 (2.2) | 32 (0.6) | <0.01 | 3.98 [2.49; 6.37] |
Antibiotics | 350 (20.0) | 896 (15.8) | <0.01 | 1.32 [1.15; 1.51] |
C+ Group (n = 1764) n (%) | C− Group (n = 5668) n (%) | p-Value | OR IC 95% | |
---|---|---|---|---|
Outcomes after ED | ||||
Discharge at home | 455 (25.8) | 3883 (68.5) | <0.01 | 0.16 [0.14; 0.18] |
Death | 9 (0.5) | 24 (0.4) | 0.68 | 1.2 [0.56; 2.59] |
Left without being seen | 4 (0.2) | 19 (0.3) | 0.63 | 0.68 [0.23; 2.00] |
Hospitalization in ward | 1128 (63.9) | 1552 (27.4) | <0.01 | 4.7 [4.2; 5.26] |
ICU from ward | 154/1128 (13.1) | 220/1552 (14.1) | 0.46 | 0.84 [0.67; 1.05] |
ICU from ED | 168 (9.5) | 190 (3.3) | <0.01 | 3.03 [2.44; 3.76] |
30 Days outcome after ED discharge | ||||
New ED visit | 72 (15.8) | 324 (8.3) | <0.01 | 0.7 [0.54; 0.91] |
New hospitalization | 56 (12.3) | 103 (2.7) | <0.01 | 1.77 [1.27; 2.46] |
Death from all cause at 30 days | 241/1702 (14.2) | 155/5558 (2.8) | <0.01 | 5.75 [4.66; 7.09] |
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Chauvin, A.; Slagman, A.; Polyzogopoulou, E.; Bjørnsen, L.P.; Adam, V.N.; Palomäki, A.; Fabbri, A.; Laribi, S.; on behalf of the EUSEM Research Network Study Group. Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study. J. Pers. Med. 2022, 12, 2085. https://doi.org/10.3390/jpm12122085
Chauvin A, Slagman A, Polyzogopoulou E, Bjørnsen LP, Adam VN, Palomäki A, Fabbri A, Laribi S, on behalf of the EUSEM Research Network Study Group. Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study. Journal of Personalized Medicine. 2022; 12(12):2085. https://doi.org/10.3390/jpm12122085
Chicago/Turabian StyleChauvin, Anthony, Anna Slagman, Effie Polyzogopoulou, Lars Petter Bjørnsen, Visnja Nesek Adam, Ari Palomäki, Andrea Fabbri, Said Laribi, and on behalf of the EUSEM Research Network Study Group. 2022. "Clinical Characteristics and Management of Patients with a Suspected COVID-19 Infection in Emergency Departments: A European Retrospective Multicenter Study" Journal of Personalized Medicine 12, no. 12: 2085. https://doi.org/10.3390/jpm12122085