Characteristics of Suspected COVID-19 Discharged Emergency Department Patients Who Returned During the First Wave

Area of Science:

• Emergency Medicine
• Infectious Diseases
• Public Health

Background:

• Limited data exists on emergency department (ED) return visits for suspected coronavirus disease 2019 (COVID-19) during the initial pandemic wave.
• Understanding predictors of return visits is crucial for patient management and healthcare resource allocation.

Purpose of the Study:

• To identify predictors of return to the ED within 72 hours for patients with suspected COVID-19 during the first wave.
• To analyze demographic, comorbidity, vital sign, and laboratory data associated with ED return visits.

Main Methods:

• Retrospective analysis of 18,599 patients with suspected COVID-19 from 14 EDs in the New York metropolitan region (March 2-April 27, 2020).
• Data included demographics, comorbidities, presenting complaints, vital signs, laboratory results, and medications at discharge.
• Statistical analysis identified factors associated with a return ED visit within 72 hours.

Main Results:

• A total of 532 (2.86%) patients returned to the ED within 72 hours; 95.49% were admitted.
• Chief complaints of fever or flu, and history of diabetes or renal disease were associated with higher return rates.
• Abnormal vital signs (temperature, respiratory rate), chest radiograph findings, and specific laboratory results (neutrophils, platelets, bicarbonate, AST) increased return risk.
• Discharge on antibiotics or corticosteroids significantly decreased the risk of return.

Conclusions:

• The low overall return rate suggests effective clinical decision-making for patient discharge during the first COVID-19 wave.
• Identifying high-risk patients through specific clinical and laboratory markers can potentially optimize emergency care and reduce readmissions.