The challenge of deciding between home-discharge versus hospitalization in COVID-19 patients: The role of initial imaging and clinicolaboratory data.
Clin Epidemiol Glob Health
; 10: 100673, 2021.
Article
in English
| MEDLINE | ID: covidwho-956963
ABSTRACT
BACKGROUND/OBJECTIVE:
It is important to predict the COVID-19 patient's prognosis, particularly in countries with lack or deficiency of medical resource for patient's triage management. Currently, WHO guideline suggests using chest imaging in addition to clinicolaboratory evaluation to decide on triage between home-discharge versus hospitalization. We designed our study to validate this recommendation to guide clinicians. This study providing some suggestions to guide clinicians for better decision making in 2020.METHODS:
In this retrospective study, patients with RT-PCR confirmed COVID-19 (N = 213) were divided in different clinical and management scenarios home-discharge, ward hospitalization and ICU admission. We reviewed the patient's initial chest CT if available. We evaluated quantitative and qualitative characteristics of CT as well as relevant available clinicolaboratory data. Chi-square, One-Way ANOVA and Paired t-test were used for analysis.RESULTS:
The finding showed that most patients with mixed patterns, pleural effusion, 5 lobes involved, total score ≥10, SpO2% ≤ 90, ESR (mm/h) ≥ 60 and WBC (103/µL) ≥ 8000 were hospitalized. Most patients with Ground-glass opacities only, ≤3 lobes involvement, peripheral distribution, SpO2% ≥ 95, ESR (mm/h) < 30 and WBC(103/µL) < 6000 were home-discharged.CONCLUSIONS:
This study suggests the use of initial chest CT (qualitative and quantitative evaluation) in addition to initial clinicolaboratory data could be a useful supplementary method for clinical management and it is an excellent decision making tool (home-discharge versus ICU/Ward admission) for clinicians.
COVID-19; COVID-19, Coronavirus disease 19; CRP, C-Reactive protein; CT scan; CT, Computed tomography; ESR, Erythrocyte sedimentation rate; GGO, Ground-glass opacities; Human coronavirus; ICU, Intensive care unit; LLL, Left Lower Lobe; LUL, Left upper lobe; Medical imaging; Prognosis; RLL, Right lower lobe; RML, Right middle lobe; RT-PCR, real-time polymerase chain reaction; RUL, Right upper lobe; SARS-CoV; SpO2, Peripheral oxygen saturation; WBC, White blood cells
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
Language:
English
Journal:
Clin Epidemiol Glob Health
Year:
2021
Document Type:
Article
Affiliation country:
J.cegh.2020.11.006
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