Open AccessClinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong
Author(s) -
Lam Rex Pui Kin,
Hung Kevin Kei Ching,
Lau Eric Ho Yin,
Lui Chun Tat,
Chan Kin Ling,
Leung Chin San,
Wong Ion Wa,
Wong Kin Wa,
Graham Colin A,
Woo Patrick Chiu Yat
Publication year - 2020
Publication title -
journal of the american college of emergency physicians open
Language(s) - English
Resource type - Journals
ISSN - 2688-1152
DOI - 10.1002/emp2.12183
Subject(s) - covid-19 , radiological weapon , coronavirus , pandemic , medicine , multicenter study , disease control , medical emergency , betacoronavirus , disease , virology , intensive care medicine , emergency medicine , infectious disease (medical specialty) , outbreak , pathology , radiology , randomized controlled trial
Objectives Little is known about the value of routine clinical assessment in identifying patients with coronavirus disease 2019 (COVID‐19) in the emergency department (ED). We aimed to compare the exposure history, signs and symptoms, laboratory, and radiographic features of ED patients who tested positive and negative for COVID‐19. Methods This was a case‐control study in 7 EDs in Hong Kong from 20 January to 29 February 2020. Thirty‐seven patients with laboratory‐confirmed COVID‐19 were age‐ and sex‐matched to 111 controls. We compared the groups with univariate analysis and calculated the odds ratio (OR) of having COVID‐19 for each characteristic that was significantly different between the groups with adjustment for age and presumed location of acquiring the infection. Results There were no significant differences in patient characteristics and reported symptoms between the groups. A positive contact history within 14 days (adjusted OR 37.61, 95% CI: 10.86–130.19), bilateral chest radiograph shadow (adjusted OR 13.19, 95% CI: 4.66–37.35), having prior medical consultation (adjusted OR 7.43, 95% 2.89–19.09), a lower white blood cell count (adjusted OR 1.30, 95% CI: 1.11–1.51), and a lower platelet count (adjusted OR 1.07, 95% CI: 1.01–1.12) were associated with a higher odds of COVID‐19 separately. A higher neutrophil count was associated with a lower odds of COVID‐19 (adjusted OR 0.77, 95% CI: 0.65–0.91). Conclusion This study highlights a number of clinical features that may be useful in identifying high‐risk patients for early testing and isolation while waiting for the test result. Further studies are warranted to verify the findings.