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pmid32692001      Emergencias 2020 ; 32 (4): 242-252
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  • Categorias diagnosticas y resultados a corto plazo en los pacientes con sospecha de COVID-19 atendidos en un servicio de urgencias #MMPMID32692001
  • Martin-Sanchez FJ; Gonzalez Del Castillo J; Valls Carbo A; Lopez Picado A; Martinez-Valero C; D Miranda J; Chacon A; Lopez-Ayala P; Chaparro D; Cozar Lopez G; Suarez-Cadenas MDM; Jerez Fernandez P; Del Toro E; Cardassay E; Angos B; Diaz Del Arco C; Rodriguez Adrada E; Montalvo Moraleda MT; Espejo Paeres C; Elvira C; Garcia Brinon MA; Leal Pozuelo JM; Ortega L; Fernandez Perez C; Gonzalez Armengol JJ
  • Emergencias 2020[Ago]; 32 (4): 242-252 PMID32692001show ga
  • OBJECTIVES: The primary objective was to describe the clinical characteristics and 30-day mortality rates in emergency department patients with coronavirus disease 2019 (COVID-19) in different diagnostic groupings. MATERIAL AND METHODS: Secondary analysis of the COVID-19 registry compiled by the emergency department of Hospital Clinico San Carlos in Madrid, Spain. We selected suspected COVID-19 cases treated in the emergency department between February 28 and March 31, 2020. The cases were grouped as follows: 1) suspected, no polymerase chain reaction (PCR) test (S/no-PCR); 2) suspected, negative PCR (S/PCR-); 3) suspected, positive PCR (S/PCR+); 4) highly suspected, no PCR, or negative PCR (HS/no or PCR-); and 5) highly suspected, positive PCR (HS/PCR+). We collected clinical, radiologic, and microbiologic data related to the emergency visit. The main outcome was 30-day all-cause mortality. Secondary outcomes were hospitalization and clinical severity of the episode. RESULTS: A total of 1993 cases (90.9%) were included as follows: S/no-PCR, 17.2%; S/PCR-, 11.4%; S/PCR+, 22.1%; HS/no PCR or PCR-, 11.7%; and HS/PCR+, 37.6%. Short-term outcomes differed significantly in the different groups according to demographic characteristics; comorbidity and clinical, radiographic, analytical, and therapeutic variables. Thirty-day mortality was 11.5% (56.5% in hospitalized cases and 19.6% in cases classified as severe). The 2 HS categories and the S/PCR+ category had a greater adjusted risk for 30-day mortality and for having a clinically severe episode during hospitalization in comparison with S/PCR- cases. Only the 2 HS categories showed greater risk for hospitalization than the S/PCR- cases. CONCLUSION: COVID-19 diagnostic groups differ according to clinical and laboratory characteristics, and the differences are associated with the 30-day prognosis.
  • |*Betacoronavirus[MESH]
  • |Adult[MESH]
  • |COVID-19[MESH]
  • |Cause of Death[MESH]
  • |Comorbidity[MESH]
  • |Confidence Intervals[MESH]
  • |Coronavirus Infections/complications/*diagnosis/*mortality/therapy[MESH]
  • |Diagnosis-Related Groups[MESH]
  • |Emergency Service, Hospital/statistics & numerical data[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/complications/*diagnosis/*mortality/therapy[MESH]
  • |Polymerase Chain Reaction/statistics & numerical data[MESH]
  • |Registries/statistics & numerical data[MESH]
  • |SARS-CoV-2[MESH]
  • |Spain/epidemiology[MESH]
  • |Symptom Assessment[MESH]
  • |Time Factors[MESH]


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