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What To Expect When Sending Patients with COVID-19 Home

By Austin Kilaru, MD, MSHP; and Kathleen Lee, MD | on November 13, 2020 | 0 Comment
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3D illustration of coronavirus COVID-19 under the microscope.

Dr. LeeDr. Lee is director of innovation and assistant professor of clinical emergency medicine at the University of Pennsylvania.

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ACEP Now: Vol 39 – No 11 – November 2020

Key Points

  • In this study, nearly 5 percent of patients with COVID-19 who were discharged home from the emergency department required hospital admission within 72 hours. More than 8 percent of patients required hospital admission within one week.
  • Risk factors for returning to the hospital included age greater than 60, abnormal findings on chest X-ray, and fever or hypoxia upon presentation for the initial ED visit. Additional risk factors for returning within one week included obesity and hypertension.
  • Emergency clinicians should discuss with patients the possibility of delayed worsening of COVID-19 illness. Patients may benefit from collaboration with outpatient clinicians or innovative monitoring systems to ensure that their symptoms can be followed while at home.

References

  1. Interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19). Centers for Disease Control and Prevention website. Accessed June 1, 2020.
  2. Gandhi RT, Lynch JB, Del Rio C. Mild or moderate Covid-19 [published online ahead of print April 24, 2020]. N Engl J Med. doi: 10.1056/NEJMcp2009249.
  3. Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network – United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69:993-998.
  4. Kilaru AS, Lee K, Snider CK, et al. Return hospital admissions among 1419 COVID-19 patients discharged from five U.S. emergency departments. Acad Emerg Med. 2020;27(10):1039-1042.
  5. Cheng J, Shroff A, Khan N, et al. Emergency department return visits resulting in admission: do they reflect quality of care? Am J Med Qual. 2016;31(6):541-551.
  6. Morgan AU, Balachandran M, Do D, et al. Remote monitoring of patients with Covid-19: cesign, implementation, and outcomes of the first 3,000 patients in COVID Watch. NEJM Catal Innov Care Deliv. 2020;10.1056/CAT.20.0342.

Pages: 1 2 3 | Single Page

Topics: coronavirusCOVID-19

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