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Characteristics and Unexpected COVID-19 Diagnoses in Resuscitation Room Patients during the COVID-19 Outbreak-A Retrospective Case Series.
Bergrath, Sebastian; Aretz, Olaf; Haake, Hendrik; Ringelstein, Adrian; Greiffendorf, Ingo; Graeven, Ullrich; Windfuhr, Jochen.
  • Bergrath S; Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.
  • Aretz O; Lehrstuhl für Anästhesiologie, Medizinische Fakultät der RWTH, Aachen, Germany.
  • Haake H; Zentrum für klinische Akut-und Notfallmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.
  • Ringelstein A; Klinik für Kardiologie und Internistische Intensivmedizin, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.
  • Greiffendorf I; Klinik für Radiologie und Neuroradiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.
  • Graeven U; Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.
  • Windfuhr J; Klinik für Hämatologie, Onkologie, Gastroenterologie und Infektiologie, Kliniken Maria Hilf, Akademisches Lehrkrankenhaus der RWTH Aachen, Mönchengladbach, Germany.
Biomed Res Int ; 2020: 2721381, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-744899
ABSTRACT

INTRODUCTION:

Emergency department (ED) triage regarding infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is challenging. During the coronavirus disease 2019 (COVID-19) outbreak in Germany, the diagnostic outcomes of critically ill patients admitted to the resuscitation room in the ED of our academic 754-bed hospital should be analyzed.

METHODS:

All resuscitation room patients between March 1st and April 15th 2020 were included in this retrospective study. Every patient with suspicion of SARS-CoV-2 infection received a pharyngeal swab for real-time polymerase chain reaction (rt-PCR), divided in the clinical subgroups of "highly suspicious for COVID-19" and "COVID-19 as differential diagnosis." All respiratory and infectious symptoms were included as at least "differential diagnosis" as an expanded suspicion strategy.

RESULTS:

Ninety-five patients were included (trauma n = 14, critically ill n = 81). Of 3 highly suspicious patients, 2 had rt-PCR positive pharyngeal swabs. In 39 patients, COVID-19 was defined as differential diagnosis, and 3 were positive for SARS-CoV-2. Of them, pharyngeal swabs were positive in 1 case, while in 2 cases, only tracheal fluid was rt-PCR positive while the pharyngeal swabs were negative. In one of these 2 cases, chest computed tomography (CT) was also negative for ground-glass opacities but showed a pulmonary abscess and pulmonary embolism.

CONCLUSION:

We recommend an expanded suspicion strategy for COVID-19 due to unexpected diagnostic outcomes. Personal protective equipment should be used in every resuscitation room operation due to unexpected cases and initial knowledge gaps. Furthermore, tracheal fluid should be tested for SARS-CoV-2 in every intubated patient due to cases with negative pharyngeal swabs and negative chest CT.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Técnicas de Laboratorio Clínico / Betacoronavirus Tipo de estudio: Reporte de caso / Estudios diagnósticos / Estudio observacional / Estudio pronóstico Tópicos: Vacunas Límite: Anciano / Femenino / Humanos / Masculino / Middle aged País/Región como asunto: Europa Idioma: Inglés Revista: Biomed Res Int Año: 2020 Tipo del documento: Artículo País de afiliación: 2020

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Neumonía Viral / Infecciones por Coronavirus / Técnicas de Laboratorio Clínico / Betacoronavirus Tipo de estudio: Reporte de caso / Estudios diagnósticos / Estudio observacional / Estudio pronóstico Tópicos: Vacunas Límite: Anciano / Femenino / Humanos / Masculino / Middle aged País/Región como asunto: Europa Idioma: Inglés Revista: Biomed Res Int Año: 2020 Tipo del documento: Artículo País de afiliación: 2020