Risk factors for later hospitalization of patients discharged from an emergency department with nonsevere COVID-19 symptoms

Emergencias. 2020 Nov;32(6):413-415.
[Article in Spanish, English]

Abstract

Objectives: To describe the clinical course of patients discharged from the emergency department (ED) with nonsevere coronavirus disease 2019 (COVID-19) and explore possible risk factors for later hospitalization.

Material and methods: Patients with nonsevere COVID-19 who were discharged from the ED were included prospectively. We explored risk factors for hospitalization after discharge.

Results: Seventy-four patients were included; 17 (23%) were hospitalized after discharge. Three (4%) of the 17 patients died. Age, lymphopenia, a high Charlson Comorbidity Index, and a shorter delay between the onset of symptoms and the first visit to the ED were associated with hospitalization afterwards, although on multivariate analysis only time less than 6 days between symptom onset and the first ED visit was associated with later hospitalization (odds ratio, 4.62; 95% CI, 1.08-19.7).

Conclusion: More than 20% of ED patients with nonsevere COVID-19 require hospitalization later.

Objetivo: Describir la evolución clínica de pacientes con COVID-19 leve tras el alta de urgencias y analizar los posibles factores de riesgo para una posterior hospitalización.

Metodo: Pacientes con COVID-19 leve dados de alta desde urgencias fueron prospectivamente incluidos. Los factores de riesgo de hospitalización fueron evaluados.

Resultados: Se incluyeron 74 pacientes y 17 (23%) requirieron hospitalización, de los cuales 3 (4%) fallecieron. La edad, la linfopenia, un mayor índice Charlson y un menor tiempo desde el inicio de los síntomas hasta la primera consulta a urgencias se asociaron a hospitalización, aunque en el análisis multivariado únicamente un tiempo desde el inicio de síntomas a la consulta a urgencias - 6 días se asoció a hospitalización (OR: 4,62: IC 95%: 1,08-19,7).

Conclusiones: Más del 20% de pacientes con COVID-19 leve dados de alta desde urgencias requiere hospitalización.

Keywords: COVID-19; Emergency department; Hospitalization; Observation; Rehospitalización; Urgencias; Vigilancia.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / complications
  • COVID-19 / diagnosis
  • COVID-19 / therapy*
  • COVID-19 Testing
  • Disease Progression
  • Emergency Service, Hospital*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Discharge
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index*