Risk factors associated with hospital transfer among mild or asymptomatic COVID-19 patients in isolation facilities in Tokyo: a case-control study

Keisuke Naito; Tomoyo Narita; Yukari Murata; Naoto Morimura

doi:10.1016/j.ijregi.2021.11.001

Risk factors associated with hospital transfer among mild or asymptomatic COVID-19 patients in isolation facilities in Tokyo: a case-control study

IJID Reg. 2022 Mar:2:8-15. doi: 10.1016/j.ijregi.2021.11.001. Epub 2021 Nov 17.

Authors

Keisuke Naito¹, Tomoyo Narita¹, Yukari Murata², Naoto Morimura³

Affiliations

¹ Bureau of Social Welfare and Public Health, Tokyo Metropolitan Government, 8-1 Nishi-Shinjuku 2-chome, Shinjuku-ku, Tokyo, Japan.
² Tokyo Metropolitan Institute of Public Health, 3-24-1 Hyakunin-cho, Shinjuku-ku, Tokyo, Japan.
³ Department of Emergency Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-Ku, Tokyo, Japan.

Abstract

Objectives: The Tokyo Metropolitan Government has been implementing facility-based isolation of asymptomatic/mild coronavirus disease (COVID-19) patients to facilitate timely hospital referral. However, there are only a few published studies in prehospital settings, and the factors associated with hospital transfer are unclear. Our study identified the factors associated with COVID-19 deterioration in a prehospital setting.

Methods: This case-control study assessed the risk factors for hospital transfer from isolation facilities and the need for ambulance transport due to deterioration among COVID-19 patients, using multivariate logistic regression analysis.

Results: In total, 10 590 patients (median age 34 years), with male predominance (61.1%), were included. 367 (3.5%) were transferred to hospital, of whom 44 (12.0%) required ambulance transport. Hypertension, diabetes, and bronchial asthma were prevalent in 704 (6.6%), 195 (1.8%), and 305 (2.9%) patients, respectively. After adjustment, older age, male sex, higher body mass index (BMI), and comorbidities (including diabetes, inflammatory bowel disease, and bronchial asthma) were associated with hospital transfer. Older age, male sex, and higher BMI significantly increased the risk of transfer by ambulance.

Conclusions: Our results may be beneficial for the development of intervention measures for probable future COVID-19 waves.

Keywords: COVID-19; Case-control; Multivariable analysis; Prehospital; Telemedicine; Tokyo.