Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis

Introduction: Patients diagnosed with coronavirus disease 2019 (COVID-19) require significant healthcare resources. While published research has shown clinical characteristics associated with severe illness from COVID-19, there is limited data focused on the emergency department (ED) discharge popul...

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Autores principales:	Iltifat Husain, James O’Neill, Rachel Mudge, Alicia Bishop, K. Alexander Soltany, Jesse Heinen, Chase Countryman, Dillon Casey, David Cline
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/c285f88f80e74a3a95b8b15fbb6d3639
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spelling	oai:doaj.org-article:c285f88f80e74a3a95b8b15fbb6d36392021-11-17T15:19:27ZClinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis1936-901810.5811/westjem.2021.9.52824https://doaj.org/article/c285f88f80e74a3a95b8b15fbb6d36392021-09-01T00:00:00Zhttps://escholarship.org/uc/item/31d0j57whttps://doaj.org/toc/1936-9018Introduction: Patients diagnosed with coronavirus disease 2019 (COVID-19) require significant healthcare resources. While published research has shown clinical characteristics associated with severe illness from COVID-19, there is limited data focused on the emergency department (ED) discharge population. Methods: We performed a retrospective chart review of all ED-discharged patients from Wake Forest Baptist Health and Wake Forest Baptist Health Davie Medical Center between April 25–August 9, 2020, who tested positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from a nasopharyngeal swab using real-time reverse transcription polymerase chain reaction (rRT-PCR) tests. We compared the clinical characteristics of patients who were discharged and had return visits within 30 days to those patients who did not return to the ED within 30 days. Results: Our study included 235 adult patients who had an ED-performed SARS-CoV-2 rRT-PCR positive test and were subsequently discharged on their first ED visit. Of these patients, 57 (24.3%) had return visits to the ED within 30 days for symptoms related to COVID-19. Of these 57 patients, on return ED visits 27 were admitted to the hospital and 30 were not admitted. Of the 235 adult patients who were discharged, 11.5% (27) eventually required admission for COVID-19-related symptoms. With 24.3% patients having a return ED visit after a positive SARS-CoV-2 test and 11.5% requiring eventual admission, it is important to understand clinical characteristics associated with return ED visits. We performed multivariate logistic regression analysis of the clinical characteristics with independent association resulting in a return ED visit, which demonstrated the following: diabetes (odds ratio [OR] 2.990, 95% confidence interval [CI, 1.21–7.40, P = 0.0179); transaminitis (OR 8.973, 95% CI, 2.65–30.33, P = 0.004); increased pulse at triage (OR 1.04, 95% CI, 1.02–1.07, P = 0.0002); and myalgia (OR 4.43, 95% CI, 2.03–9.66, P = 0.0002). Conclusion: As EDs across the country continue to treat COVID-19 patients, it is important to understand the clinical factors associated with ED return visits related to SARS-CoV-2 infection. We identified key clinical characteristics associated with return ED visits for patients initially diagnosed with SARS-CoV-2 infection: diabetes mellitus; increased pulse at triage; transaminitis; and complaint of myalgias.Iltifat HusainJames O’NeillRachel MudgeAlicia BishopK. Alexander SoltanyJesse HeinenChase CountrymanDillon CaseyDavid ClineeScholarship Publishing, University of CaliforniaarticleMedicineRMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENWestern Journal of Emergency Medicine, Vol 22, Iss 6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medicine R Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Iltifat Husain James O’Neill Rachel Mudge Alicia Bishop K. Alexander Soltany Jesse Heinen Chase Countryman Dillon Casey David Cline Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis
description	Introduction: Patients diagnosed with coronavirus disease 2019 (COVID-19) require significant healthcare resources. While published research has shown clinical characteristics associated with severe illness from COVID-19, there is limited data focused on the emergency department (ED) discharge population. Methods: We performed a retrospective chart review of all ED-discharged patients from Wake Forest Baptist Health and Wake Forest Baptist Health Davie Medical Center between April 25–August 9, 2020, who tested positive for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) from a nasopharyngeal swab using real-time reverse transcription polymerase chain reaction (rRT-PCR) tests. We compared the clinical characteristics of patients who were discharged and had return visits within 30 days to those patients who did not return to the ED within 30 days. Results: Our study included 235 adult patients who had an ED-performed SARS-CoV-2 rRT-PCR positive test and were subsequently discharged on their first ED visit. Of these patients, 57 (24.3%) had return visits to the ED within 30 days for symptoms related to COVID-19. Of these 57 patients, on return ED visits 27 were admitted to the hospital and 30 were not admitted. Of the 235 adult patients who were discharged, 11.5% (27) eventually required admission for COVID-19-related symptoms. With 24.3% patients having a return ED visit after a positive SARS-CoV-2 test and 11.5% requiring eventual admission, it is important to understand clinical characteristics associated with return ED visits. We performed multivariate logistic regression analysis of the clinical characteristics with independent association resulting in a return ED visit, which demonstrated the following: diabetes (odds ratio [OR] 2.990, 95% confidence interval [CI, 1.21–7.40, P = 0.0179); transaminitis (OR 8.973, 95% CI, 2.65–30.33, P = 0.004); increased pulse at triage (OR 1.04, 95% CI, 1.02–1.07, P = 0.0002); and myalgia (OR 4.43, 95% CI, 2.03–9.66, P = 0.0002). Conclusion: As EDs across the country continue to treat COVID-19 patients, it is important to understand the clinical factors associated with ED return visits related to SARS-CoV-2 infection. We identified key clinical characteristics associated with return ED visits for patients initially diagnosed with SARS-CoV-2 infection: diabetes mellitus; increased pulse at triage; transaminitis; and complaint of myalgias.
format	article
author	Iltifat Husain James O’Neill Rachel Mudge Alicia Bishop K. Alexander Soltany Jesse Heinen Chase Countryman Dillon Casey David Cline
author_facet	Iltifat Husain James O’Neill Rachel Mudge Alicia Bishop K. Alexander Soltany Jesse Heinen Chase Countryman Dillon Casey David Cline
author_sort	Iltifat Husain
title	Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis
title_short	Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis
title_full	Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis
title_fullStr	Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis
title_full_unstemmed	Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis
title_sort	clinical characteristics associated with return visits to the emergency department after covid-19 diagnosis
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/c285f88f80e74a3a95b8b15fbb6d3639
work_keys_str_mv	AT iltifathusain clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT jamesoneill clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT rachelmudge clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT aliciabishop clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT kalexandersoltany clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT jesseheinen clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT chasecountryman clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT dilloncasey clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis AT davidcline clinicalcharacteristicsassociatedwithreturnvisitstotheemergencydepartmentaftercovid19diagnosis
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Clinical Characteristics Associated with Return Visits to the Emergency Department after COVID-19 Diagnosis

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