Roles of CRP and Neutrophil-to-Lymphocyte Ratio in the Prediction of Readmission of COVID-19 Patients Discharged From the ED

Background Patient admissions beyond the capacity of emergency departments (EDs) have been reported since the coronavirus disease (COVID-19) pandemic. Thus, laboratory parameters to predict the readmission of patients discharged from the ED are needed. For this purpose, we investigated whether C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) could predict the readmission of patients with COVID-19. Methods Patients aged >18 years who visited the ED in October 2020 and had positive polymerase chain reaction test results were evaluated. Among these patients, those who were not hospitalized and were discharged from the ED on the same day were included in the study. The patients' readmission status within 14 days after discharge, age, sex, complaint on admission, comorbidity, systolic blood pressure, diastolic blood pressure, fever, pulse, oxygen saturation level, CRP level, blood urea nitrogen level, creatinine level, neutrophil count, lymphocyte count, and NLR were recorded. Data were compared between the groups. Results Of the 779 patients who were included in the study, 359 (46.1%) were male. The median age was 41 years (range, 31–53 years). Among these patients, those who were not hospitalized and were discharged from the ED on logistic regression analysis, age, CRP level, NLR, loss of smell and taste, and hypertension had odds ratios of 2.494, 2.207, 1.803, 0.341, and 1.879, respectively. Conclusions The strongest independent predictor of readmission within 14 days after same-day ED discharge was age > 50 years. In addition, CRP level and NLR were the laboratory parameters identified as independent predictors of ED readmission.

A New Perspective on Fever Diagnosis After the Coronavirus Disease-2019 Outbreak

Neuroleptic malignant syndrome is rare in neurology practice. It may occur due to the use of high doses of antipsychotics. It requires intensive care follow-up due to its severe complications and has high mortality. Fever, rigidity, confusion, and respiratory distress are important symptoms of the condition. It is important to note that this disease should be considered in the differential diagnosis of patients with fever, especially after the coronavirus disease-2019 disease that emerged in 2019-2020, and whose fever does not decrease as an important symptom. For these reasons, we think that the presentation of this phenomenon will be useful. (English) [ABSTRACT FROM AUTHOR] Nöroleptik malign sendrom nöroloji pratiğinde az rastlanılan, yüksek doz antipsikotiklerin kullanılması sonucu ortaya çıkan ve fatal seyretme riskinin yüksek olması nedeniyle yoğun bakım izlemi gerektiren bir tablodur. Hastada ateş, rijidite, konfüzyon, solunum sıkıntısı görülebilecek önemli semptomlardır. Özellikle 2019-2020 yılında ortaya çıkan ve önemli bir belirtisi de düşmeyen ateş yüksekliği olan koronavirüs hastalığı-19 hastalığından sonra ateş yüksekliği ile başvuran, anamnezi uygun olan hastaların ayırıcı tanısında akılda bulundurulması gereken bir hastalık olduğu konusunda farkındalığın olması önemlidir. Bu amaçlardan yola çıkarak bu olgunun sunumunun yararlı olacağını düşünmekteyiz. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)