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Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: the HOME-CoV rule
- Source :
- Internal and emergency medicine, Vol. 15, no. 8, p. 1525-1531 (2020), Internal and Emergency Medicine, Internal and Emergency Medicine, 2020, 15 (8), pp.1525-1531. ⟨10.1007/s11739-020-02483-0⟩, Internal and Emergency Medicine, Springer, 2020, 15 (8), pp.1525-1531. ⟨10.1007/s11739-020-02483-0⟩
- Publication Year :
- 2020
- Publisher :
- Springer, 2020.
-
Abstract
- In the context of the COVID-19 pandemic and overloaded hospitals, a central issue is the need to define reliable and consensual criteria for hospitalization or outpatient management in mild cases of COVID-19. Our aim was to define an easy-to-use clinical rule aiming to help emergency physicians in hospitalization or outpatient management decision-making for patients with suspected or confirmed SARS-CoV-2 infection (the HOME-CoV rule). The Delphi method was used to reach a consensus of a large panel of 51 experts: emergency physicians, geriatricians, infectious disease specialists, and ethical consultants. A preliminary list of eligible criteria was compiled based on a literature review. Four rounds of anonymized expert consultations were performed. The experts were asked to score each item as relevant, possibly relevant and non-relevant, as major or minor, and to choose the cut-off. They were also able make suggestions and remarks. Eight criteria constituting the HOME-CoV were selected: six correspond to the severity of clinical signs, one to the clinical course (clinically significant worsening within the last 24 h), and the last corresponds to the association of a severe comorbidity and an inadequate living context. Hospitalization is deemed necessary if a patient meets one or more of the criteria. In the end, 94.4% of the experts agreed with the defined rule. Thanks to the Delphi method, an absolute consensus was obtained of a large panel of experts on the HOME-CoV rule, a decision-making support mechanism for clinicians to target patients with suspected or confirmed COVID-19 requiring hospitalization. Trial registration: NCT04338841. Electronic supplementary material The online version of this article (10.1007/s11739-020-02483-0) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
Delphi Technique
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
[SDV]Life Sciences [q-bio]
Pneumonia, Viral
Expert consensus
Delphi method
Context (language use)
EM - Original
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Risk Factors
Surveys and Questionnaires
Pandemic
Outpatients
Internal Medicine
Ambulatory Care
Medicine
Humans
030212 general & internal medicine
Pandemics
Aged
Rule-based decision-making
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
business.industry
Clinical course
COVID-19
Outpatient
Middle Aged
medicine.disease
Comorbidity
3. Good health
[SDV] Life Sciences [q-bio]
Hospitalization
Infectious disease (medical specialty)
Emergency Medicine
Medical emergency
business
Outpatient management
Coronavirus Infections
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Subjects
Details
- Language :
- English
- ISSN :
- 18280447 and 19709366
- Database :
- OpenAIRE
- Journal :
- Internal and emergency medicine, Vol. 15, no. 8, p. 1525-1531 (2020), Internal and Emergency Medicine, Internal and Emergency Medicine, 2020, 15 (8), pp.1525-1531. ⟨10.1007/s11739-020-02483-0⟩, Internal and Emergency Medicine, Springer, 2020, 15 (8), pp.1525-1531. ⟨10.1007/s11739-020-02483-0⟩
- Accession number :
- edsair.doi.dedup.....d55f19aa51d8b517c681de59146a8dc7