• Adriana Gil-Rodrigo, Òscar Miró, Pascual Piñera, Guillermo Burillo-Putze, Sònia Jiménez, Alfonso Martín, Francisco Javier Martín-Sánchez, Javier Jacob, Josep María Guardiola, Eric Jorge García-Lamberechts, Begoña Espinosa, Enrique Martín Mojarro, Matilde González Tejera, Leticia Serrano, Carmen Agüera, Ester Soy, Lluís Llauger, María Ángeles Juan, Anna Palau, Carmen Del Arco, Belén Rodríguez Miranda, María Teresa Maza Vera, Alejandro Martín Quirós, Laura Tejada de Los Santos, Noemí Ruiz de Lobera, Marta Iglesias Vela, Torres GarateRaquelRServicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid, España., Aitor Alquézar-Arbé, Juan González Del Castillo, Pere Llorens, and en representación de la red de investigación SIESTA.
• Servicio de Urgencias, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Elche, Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), España.

ObjectivesTo describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) treated in hospital emergency departments (EDs) in Spain, and to assess associations between characteristics and outcomes.Material And MethodsProspective, multicenter, nested-cohort study. Sixty-one EDs included a random sample of all patients diagnosed with COVID-19 between March 1 and April 30, 2020. Demographic and baseline health information, including concomitant conditions; clinical characteristics related to the ED visit and complementary test results; and treatments were recorded throughout the episode in the ED. We calculated crude and adjusted odds ratios for risk of in-hospital death and a composite outcome consisting of the following events: intensive care unit admission, orotracheal intubation or mechanical ventilation, or in-hospital death. The logistic regression models were constructed with 3 groups of independent variables: the demographic and baseline health characteristics, clinical characteristics and complementary test results related to the ED episode, and treatments.ResultsThe mean (SD) age of patients was 62 (18) years. Most had high- or low-grade fever, dry cough, dyspnea, and diarrhea. The most common concomitant conditions were cardiovascular diseases, followed by respiratory diseases and cancer. Baseline patient characteristics that showed a direct and independent association with worse outcome (death and the composite outcome) were age and obesity. Clinical variables directly associated with worse outcomes were impaired consciousness and pulmonary crackles; headache was inversely associated with worse outcomes. Complementary test findings that were directly associated with outcomes were bilateral lung infiltrates, lymphopenia, a high platelet count, a D-dimer concentration over 500 mg/dL, and a lactate-dehydrogenase concentration over 250 IU/L in blood.ConclusionThis profile of the clinical characteristics and comorbidity of patients with COVID-19 treated in EDs helps us predict outcomes and identify cases at risk of exacerbation. The information can facilitate preventive measures and improve outcomes.

66 keywords...

hide…