• Benjamin McKay, Matthew Meyers, Leah Rivard, Jill Stoltzfus, Guhan Rammohan, and Holly Stankewicz.
• Temple/St. Luke's Medical School, 801 Ostrum Street, Bethlehem, PA 18015, United States. Electronic address: tug39112@temple.edu.
• Am J Emerg Med. 2021 Dec 1; 50: 513517513-517.

IntroductionDetermining disposition for COVID-19 patients can be difficult for emergency medicine clinicians. Previous studies have demonstrated risk factors which predict severe infection and mortality however little is known about which risk factors are associated with failure of outpatient management and subsequent admission for COVID-19 patients.MethodsWe conducted a retrospective observational chart review of patients who had a confirmed positive COVID-19 test collected during an ED visit between March 1, 2020 and October 11, 2020. Patients were divided into two groups based on presence or absence of a subsequent 30-day hospitalization. Clinical and demographic information were collected including chief complaint, triage vital signs and comorbid medical conditions.Results1038 patients were seen and discharged from a network ED with a positive SARS-CoV-2 PCR test. 94 patients (9.1%) were admitted to a hospital within 30 days of the index ED visit while 944 (90.9%) were not admitted to a network hospital within 30 days. Patients that were admitted were more likely to be older (aOR = 1.04 (95% CI 1.03-1.06)), hypoxic (aOR = 2.16 (95% CI 1.14-4.10)) and tachycardic (aOR = 2.13 (95% CI 1.34-3.38)) on initial ED presentation. Preexisting hypertension, diabetes mellitus, coronary artery disease, chronic kidney disease and malignancy were all highly significant risk factors for 30-day hospital admission following initial ED discharge (p < 0.0001).ConclusionEmergency Department providers should consider age, chief complaint, vital signs and comorbid medical conditions when determining disposition for patients diagnosed with COVID-19.Copyright © 2021 Elsevier Inc. All rights reserved.

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