Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong
Abstract Objectives Little is known about the value of routine clinical assessment in identifying patients with coronavirus disease 2019 (COVID‐19) in the emergency department (ED). We aimed to compare the exposure history, signs and symptoms, laboratory, and radiographic features of ED patients who...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-08-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12183 |
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| author | Rex Pui Kin Lam Kevin Kei Ching Hung Eric Ho Yin Lau Chun Tat Lui Kin Ling Chan Chin San Leung Ion Wa Wong Kin Wa Wong Colin A Graham Patrick Chiu Yat Woo |
| author_facet | Rex Pui Kin Lam Kevin Kei Ching Hung Eric Ho Yin Lau Chun Tat Lui Kin Ling Chan Chin San Leung Ion Wa Wong Kin Wa Wong Colin A Graham Patrick Chiu Yat Woo |
| author_sort | Rex Pui Kin Lam |
| collection | DOAJ |
| description | Abstract Objectives Little is known about the value of routine clinical assessment in identifying patients with coronavirus disease 2019 (COVID‐19) in the emergency department (ED). We aimed to compare the exposure history, signs and symptoms, laboratory, and radiographic features of ED patients who tested positive and negative for COVID‐19. Methods This was a case‐control study in 7 EDs in Hong Kong from 20 January to 29 February 2020. Thirty‐seven patients with laboratory‐confirmed COVID‐19 were age‐ and sex‐matched to 111 controls. We compared the groups with univariate analysis and calculated the odds ratio (OR) of having COVID‐19 for each characteristic that was significantly different between the groups with adjustment for age and presumed location of acquiring the infection. Results There were no significant differences in patient characteristics and reported symptoms between the groups. A positive contact history within 14 days (adjusted OR 37.61, 95% CI: 10.86–130.19), bilateral chest radiograph shadow (adjusted OR 13.19, 95% CI: 4.66–37.35), having prior medical consultation (adjusted OR 7.43, 95% 2.89–19.09), a lower white blood cell count (adjusted OR 1.30, 95% CI: 1.11–1.51), and a lower platelet count (adjusted OR 1.07, 95% CI: 1.01–1.12) were associated with a higher odds of COVID‐19 separately. A higher neutrophil count was associated with a lower odds of COVID‐19 (adjusted OR 0.77, 95% CI: 0.65–0.91). Conclusion This study highlights a number of clinical features that may be useful in identifying high‐risk patients for early testing and isolation while waiting for the test result. Further studies are warranted to verify the findings. |
| format | Article |
| id | doaj-art-54a5231bdb004df5b07eb9d91b228022 |
| institution | Kabale University |
| issn | 2688-1152 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-54a5231bdb004df5b07eb9d91b2280222025-08-20T03:52:06ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522020-08-011459760810.1002/emp2.12183Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong KongRex Pui Kin Lam0Kevin Kei Ching Hung1Eric Ho Yin Lau2Chun Tat Lui3Kin Ling Chan4Chin San Leung5Ion Wa Wong6Kin Wa Wong7Colin A Graham8Patrick Chiu Yat Woo9Emergency Medicine Unit, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Special Administrative Region ChinaAccident and Emergency Medicine Academic Unit Chinese University of Hong Kong Prince of Wales Hospital, Hong Kong Special Administrative Region ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Special Administrative Region ChinaAccident and Emergency Department Tuen Mun Hospital Hong Kong Special Administrative Region ChinaAccident and Emergency Department Queen Elizabeth Hospital Hong Kong Special Administrative Region ChinaAccident and Emergency Department Princess Margaret Hospital Hong Kong Special Administrative Region ChinaAccident and Emergency Department United Christian Hospital Hong Kong Special Administrative Region ChinaEmergency Medicine Unit, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Special Administrative Region ChinaAccident and Emergency Medicine Academic Unit Chinese University of Hong Kong Prince of Wales Hospital, Hong Kong Special Administrative Region ChinaDepartment of Microbiology, Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong Special Administrative Region ChinaAbstract Objectives Little is known about the value of routine clinical assessment in identifying patients with coronavirus disease 2019 (COVID‐19) in the emergency department (ED). We aimed to compare the exposure history, signs and symptoms, laboratory, and radiographic features of ED patients who tested positive and negative for COVID‐19. Methods This was a case‐control study in 7 EDs in Hong Kong from 20 January to 29 February 2020. Thirty‐seven patients with laboratory‐confirmed COVID‐19 were age‐ and sex‐matched to 111 controls. We compared the groups with univariate analysis and calculated the odds ratio (OR) of having COVID‐19 for each characteristic that was significantly different between the groups with adjustment for age and presumed location of acquiring the infection. Results There were no significant differences in patient characteristics and reported symptoms between the groups. A positive contact history within 14 days (adjusted OR 37.61, 95% CI: 10.86–130.19), bilateral chest radiograph shadow (adjusted OR 13.19, 95% CI: 4.66–37.35), having prior medical consultation (adjusted OR 7.43, 95% 2.89–19.09), a lower white blood cell count (adjusted OR 1.30, 95% CI: 1.11–1.51), and a lower platelet count (adjusted OR 1.07, 95% CI: 1.01–1.12) were associated with a higher odds of COVID‐19 separately. A higher neutrophil count was associated with a lower odds of COVID‐19 (adjusted OR 0.77, 95% CI: 0.65–0.91). Conclusion This study highlights a number of clinical features that may be useful in identifying high‐risk patients for early testing and isolation while waiting for the test result. Further studies are warranted to verify the findings.https://doi.org/10.1002/emp2.121832019 novel coronavirus diseaseCOVID‐19severe acute respiratory syndrome coronavirus 2emergency departmentearly diagnosiscase‐control studies |
| spellingShingle | Rex Pui Kin Lam Kevin Kei Ching Hung Eric Ho Yin Lau Chun Tat Lui Kin Ling Chan Chin San Leung Ion Wa Wong Kin Wa Wong Colin A Graham Patrick Chiu Yat Woo Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong Journal of the American College of Emergency Physicians Open 2019 novel coronavirus disease COVID‐19 severe acute respiratory syndrome coronavirus 2 emergency department early diagnosis case‐control studies |
| title | Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong |
| title_full | Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong |
| title_fullStr | Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong |
| title_full_unstemmed | Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong |
| title_short | Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong |
| title_sort | clinical laboratory and radiological features indicative of novel coronavirus disease covid 19 in emergency departments a multicenter case control study in hong kong |
| topic | 2019 novel coronavirus disease COVID‐19 severe acute respiratory syndrome coronavirus 2 emergency department early diagnosis case‐control studies |
| url | https://doi.org/10.1002/emp2.12183 |
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