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What about the others: differential diagnosis of COVID-19 in a German emergency department
- Source :
- BMC Infectious Diseases, Vol 21, Iss 1, Pp 1-8 (2021), BMC Infectious Diseases
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging. Method We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs. Results Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014). Conclusion For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections. Trial registration: German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered.
- Subjects :
- medicine.medical_specialty
Medizin
Vital signs
Infectious and parasitic diseases
RC109-216
Diagnosis, Differential
Internal medicine
Respiratory infection
Medicine
Humans
Medical diagnosis
Pandemics
Retrospective Studies
business.industry
SARS-CoV-2
Emergency department
COVID-19
Retrospective cohort study
Triage
Clinical trial
Infectious Diseases
Differential diagnosis
Clinical symptoms
business
Emergency Service, Hospital
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14712334
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Infectious Diseases
- Accession number :
- edsair.doi.dedup.....abae3f6445fc6ff43c8fdf6655d84c80