ISSN: 0034-8376
eISSN: 2564-8896





Safety and Revisit Related to Discharge the Sixty-one Spanish Emergency Department Medical Centers Without Hospitalization in Patients with COVID-19 Pneumonia. A Prospective Cohort Study UMC-Pneumonia COVID-19




Javier Jacob, Emergency Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain Arantxa Albert-Casado, Emergency Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain Juan G. Del-Castillo, Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain Pere Llorens-Soriano, Emergency Department, Hospital General de Alicante, University Miguel Hernández, Elche, Alicante, Spain Sonia Jiménez-Hernández, Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain Guillermo Burillo-Putze, Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain Alfonso Martín-Martínez, Emergency Department, Hospital Universitario de Móstoles, Madrid, Spain Francisco J. Martín-Sánchez, Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain Eric J. García-Lamberechts, Emergency Department, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain Pascual Piñera-Salmerón, Emergency Department, Hospital Reina Sofía, Murcia;, Spain Aitor Alquézar-Arbé, Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Carles Ferre-Losa, Emergency Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain María Á. Juan-Gómez, Emergency Department, Hospital Universitario Doctor Peset, Valencia, Spain Leticia Serrano-Lázaro, Emergency Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain José Noceda-Bermejo, Emergency Department, Hospital Clínico Universitario de Valencia, Valencia, Spain Manuel Salido-Mota, Emergency Department, Hospital Universitario Regional de Málaga, Málaga, Spain María J. Fortuny-Bayarri, Emergency Department, Hospital Francesc de Borja de Gandia, Valencia, Spain Matilde González-Tejera, Emergency Department, Hospital General Universitario de Elche, Alicante, Spain José M. Ferreras-Amez, Emergency Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain Elena Díaz-Fernández, Emergency Department, Hospital Universitario Sant Joan, Alicante, Spain Eva Quero-Motto, Emergency Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain Ana Peiró-Gómez, Emergency Department, Hospital de Llíria, Valencia, Spain Enrique Martín-Mojarro, Emergency Department, Hospital de Sant Pau i Santa Tecla, Tarragona, Spain Ferran Llopis-Roca, Emergency Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain Arturo Huerta-García, Emergency Department, Clinica Sagrada Familia, Barcelona, Spain Jorge Pedraza-García, Emergency Department, Hospital Valle de los Pedroche de Pozoblanco, Córdoba, Spain Napoleón Meléndez-Cálix, Emergency Department, Hospital Virgen de los Lírios, Alcoy, Alicante, Spain José V. Brazó-Aznar, Emergency Department, Hospital Universitario de la Ribera, Valencia, Spain María J. Cano-Cano, Emergency Department, Hospital Arnau de Vilanova, Valencia, Spain Óscar Miró, Emergency Department, Hospital Clínic de Barcelona, Spain


Background: Information is needed on the safety and efficacy of direct discharge from the emergency department (ED) of patients with COVID-19 pneumonia. Objectives: The objectives of the study were to study the variables associated with discharge from the ED in patients presenting with COVID-19 pneumonia, and study ED revisits related to COVID-19 at 30 days (EDR30d). Methods: Multicenter study of the SIESTA cohort including 1198 randomly selected COVID patients in 61 EDs of Spanish medical centers from March 1, 2020, to April 30, 2020. We collected baseline and related characteristics of the acute episode and calculated the adjusted odds ratios (aOR) for ED discharge. In addition, we analyzed the variables related to EDR30d in discharged patients. Results: We analyzed 859 patients presenting with COVID-19 pneumonia, 84 (9.8%) of whom were discharged from the ED. The variables independently associated with discharge were being a woman (aOR 1.890; 95%CI 1.176- 3.037), age < 60 years (aOR 2.324; 95%CI 1.353-3.990), and lymphocyte count > 1200/mm3 (aOR 4.667; 95%CI 1.045-20.839). The EDR30d of the ED discharged group was 40.0%, being lower in women (aOR 0.368; 95%CI 0.142-0.953). A total of 130 hospitalized patients died (16.8%) as did two in the group discharged from the ED (2.4%) (OR 0.121; 95%CI 0.029- 0.498). Conclusion: Discharge from the ED in patients with COVID-19 pneumonia was infrequent and was associated with few variables of the episode. The EDR30d was high, albeit with a low mortality.



Keywords: Pneumonia COVID-19. Emergency department. Revisit. Discharge.