1. Clinical and epidemiological characteristics associated with pneumonia at disease onset in patients admitted for COVID-19 to the Emergency Department of a large Hospital in Piedmont (North-Western Italy)
- Author
-
Sacerdote, C., Castiglione, A., Pagano, E., Migliore, E., Pivetta, E., Auzzas, G. M., Brentisci, C., Brunetti, F., Defile, C., Gangemi, M., Giacometti, L., Gilardetti, M., Martins, V. H., Saccona, F., Stura, A., Turco, D., Balestro, C., Zozzoli, S., Fiandra, U., Roggero, S., Silvestre, C., Scozzari, G., Scarmozzino, A., and Ciccone, G.
- Subjects
Adult ,Diarrhea ,Male ,Time Factors ,Vomiting ,Pneumonia, Viral ,Cohort study ,COVID-19 ,Pneumonia ,Aged ,Aged, 80 and over ,Comorbidity ,Dyspnea ,Emergency Service, Hospital ,Female ,Hospitals, University ,Humans ,Italy ,Leukocyte Count ,Middle Aged ,Nervous System Diseases ,Oxygen ,Prospective Studies ,Respiratory Rate ,Retrospective Studies ,Symptom Assessment ,Pandemics ,Hospital ,80 and over ,Viral ,Emergency Service ,University ,Hospitals - Abstract
to explore clinical and epidemiological characteristics associated with an imaging feature of COVID-19 pneumonia at disease onset, in order to identify factors that may be evaluable by general practitioners at patient's home, and which may lead to identify a more severe disease, needing hospitalization.this is a retrospective/prospective observational hospital cohort.the study population includes all patients consecutively admitted to the emergency department of Città della salute e della scienza University Hospital from 01.03 to 31.05.2020 with a confirmed diagnosis of SARS-CoV-2 infection.patients were classified in two groups according to the findings of X-ray imaging, lung ultrasound and chest computer tomography, as pneumonia or not pneumonia patients.in multivariable analysis, factors most strongly associated with emergency department admission with pneumonia were age, oxygen saturation90% (adj OR 4.16 ;95%CI 1.44-12.07), respiratory rate24 breaths/min (adj OR 6.50; 95%CI 2.36-17.87), fever ≥38° (adj OR 3.05; 95%CI 1.53-6.08) and the presence of gastroenteric symptoms (vomiting and diarrhea). A delay (7 days) between the appearance of the initial lung symptoms (cough and dyspnea) and the admission to the emergency department was also related to a higher probability of receiving a positive imaging report (OR 4.99; 95%CI 2,02-12,34).in order to reorganize the management of COVID-19 patients in Italy, in view of the risk of a second wave of epidemic or of local outbreaks, it would be desirable to relocate the triage, and possibly the patient's care, from hospital to home. In this scenario it is important to identify all symptoms and signs associated with COVID-19 pneumonia that would facilitate the decision-making process of GPs leading to patients hospitalization.
- Published
- 2021