CHARACTERIZATION OF PATIENTS IN THE POST-ACUTE PHASE OF COVID-19 WHO PRESENTED THEMSELVES TO AN EMERGENCY DEPARTMENT.

Background: Patients that recovered from COVID-19 may remain with symptoms which can persist for an uncertain period of time. Aim: The purpose of this study was to investigate the reasons why patients who passed the acute phase of COVID-19 presented themselves to the Emergency Department. Patients and Methods: We selected 87 patients admitted to the Emergency Department of the Bucharest University Emergency Hospital between 01.01.2021-31.05.2021. Patients had pulmonary fibrosis (11.49%), pleural effusion (16.09%) or a history of hypertension (73.56%), type 2 diabetes (42.53%), stroke (24.14%), malignant diseases (10.34%). Results: Association between neutrophil levels and acute stroke and between fibrinogen levels and alveolar condensation were identified. The percentage of deaths was significantly higher in the subgroup of subjects that had maxim 11 days of hospitalization (p=0.004); we observed a trend of association between the age of more than 51 years old and admission in the Emergency Unit at less than a month after the SARS Cov2 infection, the positive result at the RT-PCR test or a lung damage of over 30% (p<0.05). Conclusion: A significant percentage of patients that were admitted to the Emergency Unit post COVID-19 had chronic pathologies and their characteristics were associated with neutrophilia, high fibrinogen levels or length of hospitalization.

Addressability to the Emergency Department of patients with acute post-COVID 19 clinical symptoms

The long-distance post-SARS-CoV2 infection effects were partially known. The study aims to follow the evolution of the patients with acute post-COVID 19 clinical symptoms presented in the Emergency Department. Methods: We analyzed 262 presentations more than 14 days after the initial COVID-19 diagnosis and with at least one acute COVID-19-related symptom. This study included presented between 01.01 and 31.05.2021 in the Emergency Department of Bucharsti-Emergency University Hospital. Data were obtained in real-time, at the presentation, from the patients' medical charts, and afterward from SUUB's database. Results. Out of the total of 262 presentations, 40.84% required patient hospitalization. The highest number of presentations with (18.70%) or without (22.90%) hospitalization was recorded in the first month after the COVID-19 diagnosis. Patients with less than 30 days between presentations had significantly fewer hospitalization days, compared to those with more than 30 days between presentations (8.3 vs 14.14 days, p=0.009). We found a high amount of hospitalization days (1093 days), with 29.88% deaths. Conclusions: COVID-19 complications require prolonged hospitalization, with implications on the patients' quality of life, the overcrowding of intensive care facilities, high- cost treatment, and unfavorable evolution for a great number of patients.

The consistency between COVID-19 RT-PCR and IgM/IgG quick tests results

The aim of this retrospective study was to analyze the results of tests for SARSCoV- 2 performed during 07.04.2020- 20.06.2020 in the Department of the Emergency from Bucharest University Emergency Hospital. We detected 173 men and 133 women that were tested with both RT-PCR and serologic tests. The results were concordant for 287 samples (93,8%) that were collected from subjects for whom the diagnosis of COVID-19 was subsequently confirmed (10) or infirmed (277). We found that the most frequent signs and symptoms of patients with COVID-19 were at the respiratory (e.g. dyspnea), neurological (e.g. vertigo, cephalgia) and gastrointestinal (e.g. abdominal pain, vomiting, high volume of the abdomen) systems. There was no situation with positive RT-PCR and IgG and negative IgM results. In our study the RT-PCR and quick serological tests were concordant in 93,8% of cases. The combination of RT-PCR and serological testing can enhance the accuracy of COVID-19 diagnosis.