• Adam Haag, Sarah S Dhake, Jessica Folk, Urmila Ravichadran, Andrea Maric, Sarah Donlan, Chad Konchak, Loretta Au, Nirav S Shah, and Ernest Wang.
• NorthShore University HealthSystem, 2650 Ridge Ave, Evanston, IL 60201, USA. Electronic address: ahaag@northshore.org.
• Am J Emerg Med. 2021 Sep 1; 47: 239243239-243.

BackgroundThe global healthcare burden of COVID-19 continues to rise. There is currently limited information regarding the disease progression and the need for hospitalizations in patients who present to the Emergency Department (ED) with minimal or no symptoms.ObjectivesThis study identifies bounceback rates and timeframes for patients who return to the ED due to COVID-19 after initial discharge on the date of testing.MethodsUsing the NorthShore University Health System's (NSUHS) Enterprise Data Warehouse (EDW), we conducted a retrospective cohort analysis of patients who were tested positive for COVID-19 and were discharged home on the date of testing. A one-month follow-up period was included to ensure the capture of disease progression.ResultsOf 1883 positive cases with initially mild symptoms, 14.6% returned to the ED for complaints related to COVID-19. 56.9% of the mildly symptomatic bounceback patients were discharged on the return visit while 39.5% were admitted to the floor and 3.6% to the ICU. Of the 1120 positive cases with no initial symptoms, only four returned to the ED (0.26%) and only one patient was admitted. Median initial testing occurred on day 3 (2-5.6) of illness, and median ED bounceback occurred on day 9 (6.3-12.7). Our statistical model was unable to identify risk factors for ED bouncebacks.ConclusionCOVID-19 patients diagnosed with mild symptoms on initial presentation have a 14.6% rate of bounceback due to progression of illness.Published by Elsevier Inc.

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