Universität zu Köln

Schmidt-Hellerau, Kirsten, Meyer-Schwickerath, Charlotte, Paul, Gregor ORCID: 0000-0002-1075-4362, Augustin, Max, Priesner, Vanessa, Rybniker, Jan, Suarez, Isabelle, Hallek, Michael, Burst, Volker, Kolibay, Felix, Fatkenheuer, Gerd, Lehmann, Clara and Jung, Norma (2021). Providing care in isolation while awaiting SARS-CoV-2 test results Considering differential diagnoses and avoiding anchoring bias. Medicine (Baltimore), 100 (30). PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1536-5964

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Abstract

Isolation of confirmed or suspected coronavirus disease 2019 (COVID-19) cases is essential but, as symptoms of COVID-19 are non-specific and test results not immediately available, case identification at admission remains challenging. To inform optimization of triage algorithms, patient flow and patient care, we analyzed characteristics of patients admitted to an isolation ward, both severe acute respiratory syndrome coronavirus 2019 (SARS-CoV-2) positive patients and patients in which initial suspicion was not confirmed after appropriate testing. Data from patients with confirmed or suspected COVID-19 treated in an isolation unit were analyzed retrospectively. Symptoms, comorbidities and clinical findings were analyzed descriptively and associations between patient characteristics and final SARS-CoV-2 status were assessed using univariate regression. Eighty three patients (49 SARS-CoV-2 negative and 34 positive) were included in the final analysis. Of initially suspected COVID-19 cases, 59% proved to be SARS-CoV-2-negative. These patients had more comorbidities (Charlson Comorbidity Index median 5(interquartile range [IQR] 2.5, 7) vs 2.7(IQR 1, 4)), and higher proportion of active malignancy than patients with confirmed COVID-19 (47% vs 15%; P = .004), while immunosuppression was frequent in both patient groups (20% vs 21%; P = .984). Of SARS-CoV-2 negative patients, 31% were diagnosed with non-infectious diseases. A high proportion of patients (59%) triaged to the isolation unit were tested negative for SARS-CoV-2. Of these, many suffered from active malignancy (47%) and were immunosuppressed (20%). Non-infectious diseases were diagnosed in 31%, highlighting the need for appropriate patient flow, timely expert medical care including evaluation for differential diagnostics while providing isolation and ruling out of COVID-19 in these patients with complex underlying diseases.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schmidt-Hellerau, Kirsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer-Schwickerath, Charlotte UNSPECIFIED UNSPECIFIED UNSPECIFIED Paul, Gregor UNSPECIFIED orcid.org/0000-0002-1075-4362 UNSPECIFIED Augustin, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED Priesner, Vanessa UNSPECIFIED UNSPECIFIED UNSPECIFIED Rybniker, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Suarez, Isabelle UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Burst, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Kolibay, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Fatkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Clara UNSPECIFIED UNSPECIFIED UNSPECIFIED Jung, Norma UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-578584
DOI:	10.1097/MD.0000000000026720
Journal or Publication Title:	Medicine (Baltimore)
Volume:	100
Number:	30
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1536-5964
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language COVID-19 Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/57858