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Eurasian Journal of Emergency Medicine
By Yılmaz Özgül, Muhammed Ediz Sarıhan and Talat Kılıç.
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To evaluate adults with previously documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who presented to the emergency department with new or persistent symptoms at least 4 weeks after acute coronavirus disease 2019 (COVID-19). Materials and Methods: We examined presenting symptoms; demographic and clinical characteristics, laboratory and imaging findings; and factors concurrently associated with all-cause hospital admission during the index post-acute emergency department encounter. Medical records of 760 patients with documented previous SARS-CoV-2 infection who presented to the emergency department between January 2020 and November 2022 were reviewed. Patients with ongoing polymerase chain reaction positivity (n=54), with complaints clearly unrelated to the post-acute presentation (n=74), with incomplete laboratory data (n=84), or aged <18 years (n=48) were excluded. The final cohort comprised 500 patients who presented at least 4 weeks after the documented acute COVID-19 diagnosis.
Of the 500 patients, 275 (55.0%) were female and 225 (45.0%) were male; the median age was 52 years (range, 18-90). Thirty patients had an all-cause hospital admission during the index post-acute emergency department encounter. Admission was more frequent among patients who had required hospital-based care during acute COVID-19 than among those managed as outpatients (19.3% vs. 2.3%; p<0.001). After Holm adjustment, white blood cell count, neutrophil count, blood urea nitrogen, C-reactive protein, procalcitonin (PCT), N-terminal pro-B-type natriuretic peptide, and D-dimer levels were significantly higher among hospitalized patients. In the post hoc exploratory Firth-penalized multivariable model, older age, higher PCT and D-dimer levels, and acute-period hospitalization were associated with same-encounter admission after adjustment.
Older age, higher concurrent PCT and D-dimer levels, and hospitalization during acute COVID-19 were associated with all-cause admission at the index post-acute emergency department encounter. These exploratory same-encounter associations do not establish prediction, causation, or hospitalization attributable to a post-COVID condition, and they require external validation.
Published in Eurasian Journal of Emergency Medicine. The abstract is shown as published and remains the work of its authors; read the full article at the source.
eajem.com/articles/clinical-characteristics-and-factors-associated-with-same-enc
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