ABSTRACT
COVID-19 is a systemic disease with SARS-CoV-2-induced acute respiratory tract involvement with variable mortality and morbidity. It is at the forefront of health center applications all over the world, which started in December 2019 and was accepted as a pandemic by the World Health Organization. Deciding hospitalization or isolation at home during a pandemic is an essential process for predicting mortality. The CHOSEN (COVID Home Safely Now) risk score has emerged because of the densities experienced in hospitals and the physicians' decision to be discharged from patient clinics. Our aim in this study is to investigate the performance of the CHOSEN score in predicting the prognosis in COVID-19 patients. Methods: This is a retrospective cross-sectional study. COVID-19 patients who were 18 years and older admitted to the emergency department with COVID-19 symptoms are included in the study. Age, gender, albumin, SPO2 levels, and outcomes of COVID-19 patients who applied to our emergency department between 1 March 2021 and 15 April 2021 were recorded and the CHOSEN scores were calculated. The scores 0-29 are grouped as unlikely suitable for discharge. The scores 30-55 are grouped as likely suitable for discharge. We compared the groups regarding outcomes. Results: Four hundred fifty-nine patients were included in the analysis. The median age was 51 (interquartile range (IQR)=27), and 52.3% were female. The hospitalization rate was 37.7%, with a 5.9% rate of ICU admission, and 14-day-mortality was 2.6%. The Median CHOSEN score was 40 (IQR=9.00). The clinical decisions of hospitalization were significantly associated with CHOSEN scores (p Discussion: CHOSEN Risk score for COVID-19 patients is an effective tool to predict the requirement of hospitalization for patients with COVID with more than 90% accuracy. It is a promising tool to effectively organize the limited resources of monitor, bed, and oxygen support for high admission rates in the pandemic.
ABSTRACT
Objective: To evaluate the change in the severity, frequency, and characteristics of pediatric trauma patients presented to the emergency department (ED) during the coronavirus disease-2019 (COVID-19) outbreak. Methods: A retrospective corn parative study was conducted in the ED of a tertiary trauma center in Istanbul, Turkey. Trauma patients aged under 18 years who presented to the ED between May 1st and June 30st, 2020 were included. The same dates of the previous year were included as a control group. Comparison of Manchester Triage Scale (MTS), disposition, injury characteristics, the location of the injury, region of injury, and ED length of stay (LOS) was done. Results: 2,779 patients were included. There were a 60% reduction in total ED visits and a 50% reduction in daily ED visits. MTS orange code patients (1.1% vs 1.8%) did not change while MTS green code (69.6% vs 41.8%) decreased significantly. Arrival by ambulance (5.8% vs 11.5%) increased (p<0.001). Penetrating (7.2% vs 27.3%), in-home (48.1% vs 65.1%), and upper limb (27.1 vs 34.4%) injuries increased (p<0.001). Fracture (19.0% vs 14.1%) and blunt trauma (90.7% vs 70.9%) frequency, and fall from ground level (64.5% vs 49.3%) injuries decreased significantly. The ward and intensive care unit (ICU) admissions did not change and ED LOS decreased (p<0.001). Conclusion: We highlighted that there was no change in critical pediatric trauma visits during the COVID-19 pandemic. There is still a need for ward and ICU beds for pediatric trauma patients. The change in injury severity and injury characteristics should be kept in mind while pandemic rearrangements were planned.