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Association between COVID-19 diagnosis and presenting chief complaint from New York City triage data.
Clifford, Christopher T; Pour, Trevor R; Freeman, Robert; Reich, David L; Glicksberg, Benjamin S; Levin, Matthew A; Klang, Eyal.
  • Clifford CT; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Christopher.clifford@mountsinai.org.
  • Pour TR; Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Trevor.pour@mountsinai.org.
  • Freeman R; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Robert.freeman@mountsinai.org.
  • Reich DL; Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: David.reich@mountsinai.org.
  • Glicksberg BS; The Hasso Plattner Institute of Digital Health at Mount Sinai, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Benjamin.glicksberg@mssm.edu.
  • Levin MA; Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Matthew.levin@mssm.org.
  • Klang E; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA. Electronic address: Eyal.klang@mountsinai.org.
Am J Emerg Med ; 46: 520-524, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-912013
ABSTRACT
BACKGROUND AND

AIM:

New York City (NYC) is an epicenter of the COVID-19 pandemic in the United States. Proper triage of patients with possible COVID-19 via chief complaint is critical but not fully optimized. This study aimed to investigate the association between presentation by chief complaints and COVID-19 status.

METHODS:

We retrospectively analyzed adult emergency department (ED) patient visits from five different NYC hospital campuses from March 1, 2020 to May 13, 2020 of patients who underwent nasopharyngeal COVID-19 RT-PCR testing. The positive and negative COVID-19 cohorts were then assessed for different chief complaints obtained from structured triage data. Sub-analysis was performed for patients older than 65 and within chief complaints with high mortality.

RESULTS:

Of 11,992 ED patient visits who received COVID-19 testing, 6524/11992 (54.4%) were COVID-19 positive. 73.5% of fever, 67.7% of shortness of breath, and 65% of cough had COVID-19, but others included 57.5% of weakness/fall/altered mental status, 55.5% of glycemic control, and 51.4% of gastrointestinal symptoms. In patients over 65, 76.7% of diarrhea, 73.7% of fatigue, and 69.3% of weakness had COVID-19. 45.5% of dehydration, 40.5% of altered mental status, 27% of fall, and 24.6% of hyperglycemia patients experienced mortality.

CONCLUSION:

A novel high risk COVID-19 patient population was identified from chief complaint data, which is different from current suggested CDC guidelines, and may help triage systems to better isolate COVID-19 patients. Older patients with COVID-19 infection presented with more atypical complaints warranting special consideration. COVID-19 was associated with higher mortality in a unique group of complaints also warranting special consideration.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Triage / Emergency Service, Hospital / Pandemics / COVID-19 Testing / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Am J Emerg Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Triage / Emergency Service, Hospital / Pandemics / COVID-19 Testing / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Am J Emerg Med Year: 2021 Document Type: Article