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Retrospective analysis of asymptomatic COVID-19 patients presenting to emergency department
Nazli Gormeli Kurt1, Celal Gunes2
1Department of Emergency Medicine, Ankara City Hospital, Ankara, Turkey.
Objective:
In this study, we aimed to investigate the clinical and demographic characteristics of asymptomatic COVID-19 cases incidentally diagnosed at the emergency department.
Methodology:
This study retrospectively analysed the medical data of patients who presented to the emergency department, between March 1 and May 1, 2020, without COVID-19 symptoms such as fever, cough, myalgia on admission but were incidentally detected to have thoracic computerised tomography (CT) findings suggestive of COVID-19. The patients' sociodemographic and epidemiological characteristics, laboratory test results, clinical and radiological findings, treatment protocols and prognoses were recorded.
Results:
We incidentally diagnosed COVID-19 pneumonia in 81 asymptomatic patients. All patients presented to the emergency department with traumatic injuries. Of these, 38 (46%) were injured in in-vehicle traffic accidents; 27 (34%) out-of-vehicle traffic accidents; 14 (18%) simple falls; and 2 (2%) falls from a height. Only 42 (48%) patients had a history of suspected contact with a COVID-19 positive individual. The mean time to symptom onset of 81 patients was 5 ± 2 days. An analysis based on thoracic computerised tomography findings showed that the common finding found in all patients was ground glass opacity (GGO). While 55 (68%) patients had GGO alone, 10 (12%) had additional fine reticulations; 6 (7%) had an additional halo sign; 6 (7%) had an additional air bronchogram and 4 (5%) had an additional area of consolidation. None of the patients died during follow-up, and all of them were discharged.
Conclusion:
Early identification and isolation of asymptomatic patients are of great importance for reducing the speed of propagation of the COVID-19 pandemic. Incidentally diagnosed cases have made us consider that there is a need to increase the number of screening tests. We also believe that healthcare staff should suspect COVID-19 pneumonia in every patient irrespective of presentation type, place importance on the use of personal protective equipment (PPE), and not examine any patient without wearing PPE.
