tetano
Editor, Senior Moderator
Emergencias
. 2020 Ago;32(4):242-252.
Diagnostic groups and short-term outcomes in suspected COVID-19 cases treated in an emergency department
[Article in Spanish, En]
F Javier Mart?n-S?nchez[SUP] 1 [/SUP], Juan Gonz?lez Del Castillo[SUP] 2 [/SUP], Adri?n Valls Carb?[SUP] 3 [/SUP], Amanda L?pez Picado[SUP] 4 [/SUP], Carmen Mart?nez-Valero[SUP] 4 [/SUP], Juande D Miranda[SUP] 5 [/SUP], Ana Chac?n[SUP] 6 [/SUP], Pedro L?pez-Ayala[SUP] 7 [/SUP], David Chaparro[SUP] 8 [/SUP], Gabriel Cozar L?pez[SUP] 8 [/SUP], Mar?a Del Mar Su?rez-Cadenas[SUP] 2 [/SUP], Pablo Jerez Fern?ndez[SUP] 8 [/SUP], Enrique Del Toro[SUP] 8 [/SUP], Eduardo Cardassay[SUP] 8 [/SUP], Beatriz Ang?s[SUP] 8 [/SUP], Cristina D?az Del Arco[SUP] 9 [/SUP], Esther Rodr?guez Adrada[SUP] 4 [/SUP], Mar?a Teresa Montalvo Moraleda[SUP] 3 [/SUP], Carolina Espejo Paeres[SUP] 10 [/SUP], Carlos Elvira[SUP] 6 [/SUP], Miguel ?ngel Garc?a Bri??n[SUP] 2 [/SUP], Jos? M? Leal Pozuelo[SUP] 11 [/SUP], Luis Ortega[SUP] 9 [/SUP], Cristina Fern?ndez P?rez[SUP] 12 [/SUP], Juan Jorge Gonz?lez Armengol[SUP] 1 [/SUP]
Affiliations
Abstract
in En , Spanish
Objectives: The primary objective was to describe the clinical characteristics and 30-day mortality rates in emergency department patients with coronavirus disease 2019 (COVID-19) in different diagnostic groupings.
Material and methods: Secondary analysis of the COVID-19 registry compiled by the emergency department of Hospital Cl?nico San Carlos in Madrid, Spain. We selected suspected COVID-19 cases treated in the emergency department between February 28 and March 31, 2020. The cases were grouped as follows: 1) suspected, no polymerase chain reaction (PCR) test (S/no-PCR); 2) suspected, negative PCR (S/PCR-); 3) suspected, positive PCR (S/PCR+); 4) highly suspected, no PCR, or negative PCR (HS/no or PCR-); and 5) highly suspected, positive PCR (HS/PCR+). We collected clinical, radiologic, and microbiologic data related to the emergency visit. The main outcome was 30-day all-cause mortality. Secondary outcomes were hospitalization and clinical severity of the episode.
Results: A total of 1993 cases (90.9%) were included as follows: S/no-PCR, 17.2%; S/PCR-, 11.4%; S/PCR+, 22.1%; HS/no PCR or PCR-, 11.7%; and HS/PCR+, 37.6%. Short-term outcomes differed significantly in the different groups according to demographic characteristics; comorbidity and clinical, radiographic, analytical, and therapeutic variables. Thirty-day mortality was 11.5% (56.5% in hospitalized cases and 19.6% in cases classified as severe). The 2 HS categories and the S/PCR+ category had a greater adjusted risk for 30-day mortality and for having a clinically severe episode during hospitalization in comparison with S/PCR- cases. Only the 2 HS categories showed greater risk for hospitalization than the S/PCR- cases.
Conclusion: COVID-19 diagnostic groups differ according to clinical and laboratory characteristics, and the differences are associated with the 30-day prognosis.
Keywords: COVID-19; Emergency department; Mortalidad; Mortality; PCR; Polymerase chain reaction (PCR); SARS-CoV-2; SARS-Cov-2; Servicio de urgencias.
. 2020 Ago;32(4):242-252.
Diagnostic groups and short-term outcomes in suspected COVID-19 cases treated in an emergency department
[Article in Spanish, En]
F Javier Mart?n-S?nchez[SUP] 1 [/SUP], Juan Gonz?lez Del Castillo[SUP] 2 [/SUP], Adri?n Valls Carb?[SUP] 3 [/SUP], Amanda L?pez Picado[SUP] 4 [/SUP], Carmen Mart?nez-Valero[SUP] 4 [/SUP], Juande D Miranda[SUP] 5 [/SUP], Ana Chac?n[SUP] 6 [/SUP], Pedro L?pez-Ayala[SUP] 7 [/SUP], David Chaparro[SUP] 8 [/SUP], Gabriel Cozar L?pez[SUP] 8 [/SUP], Mar?a Del Mar Su?rez-Cadenas[SUP] 2 [/SUP], Pablo Jerez Fern?ndez[SUP] 8 [/SUP], Enrique Del Toro[SUP] 8 [/SUP], Eduardo Cardassay[SUP] 8 [/SUP], Beatriz Ang?s[SUP] 8 [/SUP], Cristina D?az Del Arco[SUP] 9 [/SUP], Esther Rodr?guez Adrada[SUP] 4 [/SUP], Mar?a Teresa Montalvo Moraleda[SUP] 3 [/SUP], Carolina Espejo Paeres[SUP] 10 [/SUP], Carlos Elvira[SUP] 6 [/SUP], Miguel ?ngel Garc?a Bri??n[SUP] 2 [/SUP], Jos? M? Leal Pozuelo[SUP] 11 [/SUP], Luis Ortega[SUP] 9 [/SUP], Cristina Fern?ndez P?rez[SUP] 12 [/SUP], Juan Jorge Gonz?lez Armengol[SUP] 1 [/SUP]
Affiliations
- PMID: 32692001
Abstract
in En , Spanish
Objectives: The primary objective was to describe the clinical characteristics and 30-day mortality rates in emergency department patients with coronavirus disease 2019 (COVID-19) in different diagnostic groupings.
Material and methods: Secondary analysis of the COVID-19 registry compiled by the emergency department of Hospital Cl?nico San Carlos in Madrid, Spain. We selected suspected COVID-19 cases treated in the emergency department between February 28 and March 31, 2020. The cases were grouped as follows: 1) suspected, no polymerase chain reaction (PCR) test (S/no-PCR); 2) suspected, negative PCR (S/PCR-); 3) suspected, positive PCR (S/PCR+); 4) highly suspected, no PCR, or negative PCR (HS/no or PCR-); and 5) highly suspected, positive PCR (HS/PCR+). We collected clinical, radiologic, and microbiologic data related to the emergency visit. The main outcome was 30-day all-cause mortality. Secondary outcomes were hospitalization and clinical severity of the episode.
Results: A total of 1993 cases (90.9%) were included as follows: S/no-PCR, 17.2%; S/PCR-, 11.4%; S/PCR+, 22.1%; HS/no PCR or PCR-, 11.7%; and HS/PCR+, 37.6%. Short-term outcomes differed significantly in the different groups according to demographic characteristics; comorbidity and clinical, radiographic, analytical, and therapeutic variables. Thirty-day mortality was 11.5% (56.5% in hospitalized cases and 19.6% in cases classified as severe). The 2 HS categories and the S/PCR+ category had a greater adjusted risk for 30-day mortality and for having a clinically severe episode during hospitalization in comparison with S/PCR- cases. Only the 2 HS categories showed greater risk for hospitalization than the S/PCR- cases.
Conclusion: COVID-19 diagnostic groups differ according to clinical and laboratory characteristics, and the differences are associated with the 30-day prognosis.
Keywords: COVID-19; Emergency department; Mortalidad; Mortality; PCR; Polymerase chain reaction (PCR); SARS-CoV-2; SARS-Cov-2; Servicio de urgencias.