Epidemiology and clinical characteristics of COVID-19 patients admitted to the emergency department

ABSTRACT

Introduction: The COVID-19 epidemic has been developing in Tunisia officially since March 2, 2020. Since the spread of the epidemic, the governorate of Mahdia has experienced 23,271 cases of contamination including 673 deaths and 20,739 cases of recovery. The aim of this study is to describe the epidemiological and clinical characteristics of patients with COVID-19 who have been hospitalized in the emergency department of Mahdia. Methods: This is a retrospective study, carried out in the Emergency Department of Mahdia over a period of 12 months extending from September 2020 until August 2021. We included patients over 18 years-old hospitalized with COVID-19 lung disease confirmed either by RT-PCR or rapid antigen testing. For all patients included, demographic, clinical, biological and therapeutic data were collected as well as the patient's outcome. Results: A total of 976 patients were included, the mean age was 67. Patients over 70 years of age accounted for 40%. The sex ratio 1.06. 74.2% of patients had at least one comorbidity, including hypertension (52%) and diabetes (46%). The most frequent clinical sign was dyspnea (77%). Initial management included low flow oxygen therapy in 319 patients (33%), high flow oxygen therapy in 426 patients (44%). And 102 patients (10%) received non-invasive ventilation and 13 (1%) received invasive ventilation. Severe forms are frequent (43% of cases). Patients admitted to the emergency department only (360 or 37%), compared to those transferred to intensive care (209, 21%) and to the COVID department (373, 38%), were older [age average respectively 73 years (SD ± 13);66 (SD ± 13);61 (SD ± 13);p = 0.001] and likely to have at least one comorbidity (79%, 76%, 73% respectively). The case fatality rate was 31.5% in all patients. Conclusions: In this study, our patients were mainly elderly, male, having at least one comorbidity with a high mortality rate, hence the need for a prospective study specifying the predictive factors of mortality.