Outcomes of Discharged Coronavirus Disease of 2019 Patients from an Emergency Department at a Tertiary Care Hospital: A Pilot Study

Alwadei Mohamed^1, , Taher Nada², Saleh Yasir³, Alharthi Bassam³, Kutbi Omniyyah³, Algaedy Renad⁴ and Banah Anas⁵

¹Emergency Medicine Department, King Abdullah Medical City, Makkah, Saudi Arabia

²College of Medicine, King Saud bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia

³Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia

⁴Faculty of Medicine, ibn Sina National College, Jeddah, Saudi Arabia

⁵Emergency Medicine Department, King Abdullah Medical City, Makkah Healthcare Cluster, Makkah, Saudi Arabia

Cite this paper

Alwadei Mohamed, Taher Nada, Saleh Yasir, Alharthi Bassam, Kutbi Omniyyah, Algaedy Renad and Banah Anas. Outcomes of Discharged Coronavirus Disease of 2019 Patients from an Emergency Department at a Tertiary Care Hospital: A Pilot Study. American Journal of Clinical Medicine Research. 2021; 9(2):43-47. doi: 10.12691/AJCMR-9-2-2

Abstract

Background: Patients with Coronavirus Disease of 2019 (COVID-19) infection can develop varying degrees of illness severity. A critical decision point for all frontline providers affects to whether a given patient is at high risk for severe illness and thus needs inpatient care as opposed to recovery at home. Aim of the study: The aim of the current study is to assess the outcomes of the suspected Covid-19 patients who were swabbed after presenting to the Emergency Department at King Abdullah Medical City and their result came positive for Covid-19. Subjects and Methods: A retrospective pilot study was conducted at KAMC, Holy Makkah-Saudi Arabia. Fifty-one positive covid-19 patients were included at this study. The demographic data, presenting complaint, The Canadian Triage and Acuity Scale (CTAS), comorbidities, discharging vital signs, and hospital revisits were extracted from the electronic medical records (EMR) using Trakcare system. Patients were followed up by phone calls after discharge from the ER for 14 days. Information regarding KAMC hospital revisit or other hospital revisit, quarantine location and length, seeking medical advice, and non-hospital revisit were obtained from the patients or their relatives. Data was collected from15^th of March 2020 till 15^th of June 2020. Then the outcomes were assessed. Chi-square test and independent sample t-test were used to compare proportions and continuous variables, respectively. The binary logistic regression calculated odds ratios (OR) and 95% confidence intervals (95% CI for the interested predictors. P <0.05 was considered statistically significant. Results: oxygen saturation was found to be the only independent predictor of revisiting COVID 19 patients (OR=0.46; P=0.009). Conclusion: oxygen saturation was found to be the only independent predictor of revisiting COVID 19 patients.

Keywords

COVID-19, outcomes, emergency department

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Lanham, D., Roe, J., Chauhan, A., Evans, R., Hillman, T., Logan, S., & Heightman, M. (2021). COVID-19 emergency department discharges: an outcome study. Clinical Medicine.
[2]	Grimm CA. Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020. US Department of health and human services OoIG2020. p. 1-41.
[3]	Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: a descriptive, cross-sectional, multicenter study. Am J Gastroenterol 2020; 115: 766-73.
[4]	Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62.
[5]	Health Mo. Hospital admission criteria for COVID-19 patients Version 1.1: Ministry of Health; 2020. Available from: https://www.moh.gov.sa/Ministry/MediaCenter/Publications/Documents/admission-criteria.pdf.
[6]	Ministry of Health- Kingdom of Saudi Arabia. 2021. MOH-therapeutic-protocol-for-COVID-19. pdf. https://www.moh.gov.sa/Ministry/MediaCenter/Publications/Documents/MOH-therapeutic-protocol-for-COVID-19.pdf.
[7]	Somani S, Richter F, Fuster V, De Freitas J, Naik N, Sigel K, et al. Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization For COVID-19. medRxiv. 2020.
[8]	Liang W, Liang H, Ou L, et al. Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. JAMA Intern Med 2020; 180: 1-9.
[9]	Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020; 7(1): 4. 7.
[10]	Wang X, Xu H, Jiang H, et al. Follow-up study of 131 COVID-19 discharged patients: is the current Chinese discharge criteria reliable? Preprint at: https://ssrn.com/abstract=3551342. Posted March 18, 2020.
[11]	KILARU, Austin S., et al. Return hospital admissions among 1419 Covid-19 patients discharged from five US emergency departments. Academic Emergency Medicine, 2020, 27. 10: 1039-1042.‏
[12]	LANHAM, David, et al. COVID-19 emergency department discharges: an outcome study. Clinical Medicine, 2021.
[13]	YUAN, Neal, et al. Pseudo-safety in a cohort of patients with COVID-19 discharged home from the emergency department. Emergency Medicine Journal, 2021, 38.4: 304-307.