• Beatriz López-Barbeito, Ana García-Martínez, Blanca Coll-Vinent, Arrate Placer, Carme Font, Carmen Rosa Vargas, Carolina Sánchez, Daniela Piñango, Elisenda Gómez-Angelats, David Curtelin, Emilio Salgado, Francisco Aya, Gemma Martínez-Nada, José Ramón Alonso, Julia García-Gozalbes, Leticia Fresco, Miguel Galicia, Milagrosa Perea, Miriam Carbó, Nerea Iniesta, Ona Escoda, Rafael Perelló, Sandra Cuerpo, Vanesa Flores, Xavier Alemany, Óscar Miró, Mª Del Mar Ortega, and Grupo de Trabajo sobre la atención de la COVID-19 en Urgencias (COVID19-URG).
• Área de Urgencias, Hospital Clinic, Universitat de Barcelona, España.
• Emergencias. 2020 Nov 1; 32 (6): 386-394.

ObjectivesTo analyze emergency department (ED) revisits from patients discharged with possible coronavirus disease 2019 (COVID-19).Material And MethodsRetrospective observational study of consecutive patients who came to the ED over a period of 2 months and were diagnosed with possible COVID-19. We analyzed clinical and epidemiologic variables, treatments given in the ED, discharge destination, need to revisit, and reasons for revisits. Patients who did or did not revisit were compared, and factors associated with revisits were explored.ResultsThe 2378 patients included had a mean age of 57 years; 49% were women. Of the 925 patients (39%) discharged, 170 (20.5%) revisited the ED, mainly for persistence or progression of symptoms. Sixty-six (38.8%) were hospitalized. Odds ratios (ORs) for the following factors showed an association with revisits: history of rheumatologic disease (OR, 2.97; 95% CI, 1.10-7.99; P = .03), digestive symptoms (OR, 1.73; 95% CI, 1.14-2.63; P = .01), respiratory rate over 20 breaths per minute (OR, 1.03; 95% CI, 1.0-1.06; P = .05), and corticosteroid therapy given in the ED (OR, 7.78; 95% CI, 1.77-14.21, P = .01). Factors associated with hospitalization after revisits were age over 48 years (OR, 2.57; 95% CI, 1 42-4.67; P = .002) and fever (OR, 4.73; 95% CI, 1.99-11.27; P = .001).ConclusionPatients under the age of 48 years without comorbidity and with normal vitals can be discharged from the ED without fear of complications. A history of rheumatologic disease, fever, digestive symptoms, and a respiratory rate over 20 breaths per minute, or a need for corticosteroid therapy were independently associated with revisits. Fever and age over 48 years were associated with a need for hospitalization.

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