ABSTRACT
Background & Objective: Hospital readmissions are common and expensive. Identifying the patients who are at high risk of readmission can decrease readmission cases. Hence, in the present study, the clinical characteristics, biomarker results, and Computed Tomography (CT) criteria of all the readmitted patients were assessed. Materials & Methods: Data of 98 readmitted patients to the Baqiyatallah Hospital in Tehran were reviewed from December 22, 2019 through June 20, 2020. We classified the readmitted patients into three groups: patients (1) without COVID-19 symptoms, (2) with suspected COVID-19, and (3) with confirmed COVID-19 infection. Results: Our data revealed that the frequency of gender was significantly different between the groups (with higher frequency in men). The duration between the two admissions was significantly low in the confirmed COVID-19 group. Ischemic heart disease, hypertension, and diabetes mellitus were more common in confirmed COVID-19 group. High levels of CRP, and ESR were detected in the confirmed COVID-19 group. During the first admission, the WBC count was significantly lower in the confirmed COVID-19 group, the RBC count and hemoglobin level were significantly higher in both first and second admissions in the confirmed COVID-19 group. Most of the patients had bilateral lung lesions and ground glass opacities (GGO) in their CT Scans in the second admission. Conclusion: Our data suggested that the older men and ischemic heart disease, hypertension, and diabetes mellitus had a high risk of hospital readmission in COVID-19. The confirmed COVID-19 group showed a shorter time to be readmitted.
ABSTRACT
Triage is a familiar concept for all who work at the forefront of the treatment of patients and the emergency medical staff know their duty in different situations including crisis and epidemics. Accordingly, the coronavirus outbreak has also a major effect on the emergency department (ED) as it changes the routine ED function. Our main question was what are the main triage challenges in the recent pandemic and how we could overcome these challenges? Therefore, a search of the main Web databases was performed for articles published till May 1st, 2020 using various related keywords. In various steps, the title, summary, methodology, results, and discussion of the selected studies were assessed to find out the recent triage strategies in the COVID-19 outbreak. Hence, all the available and related English review articles, case series, and experimental studies were evaluated. Among 200 studies initially reviewed, 59 met the study criteria for the final assessment. COVID-19 puts a significant load on public health services and potential damage to social and psychiatric situations by marked morbidity and mortality. In line with the various presentations and according to the changing of the COVID-19 epidemic to a worldwide pandemic problem, the management and treatment protocols changed several times. Accordingly, the local and even global hospital protocols were changed as well. The first simple concept of coronavirus triage in an emergency department is the separation of COVID-19 infected patients from the others. This approach has been practiced around the world. Changing the ED layout from a usual triage or fast track set to an isolated room is necessary for such a pandemic situation. It is very important to consider staff communication and the application of PPE. All the efforts should be taken to protect patients as well as the medical staff from unnecessary exposure and infection;this serves to keep the health facilities working well in the outbreak and diffusion of SARS-CoV-2.