Journal of Clinical Medicine (Sep 2022)
Evaluation of a Triage Checklist for Mild COVID-19 Outpatients in Predicting Subsequent Emergency Department Visits and Hospitalization during the Isolation Period: A Single-Center Retrospective Study
- Yasuhiro Tanaka,
- Kazuko Yamamoto,
- Shimpei Morimoto,
- Takeshi Nabeshima,
- Kayoko Matsushima,
- Hiroshi Ishimoto,
- Nobuyuki Ashizawa,
- Tatsuro Hirayama,
- Kazuaki Takeda,
- Hiroshi Gyotoku,
- Naoki Iwanaga,
- Shinnosuke Takemoto,
- Susumu Fukahori,
- Takahiro Takazono,
- Hiroyuki Yamaguchi,
- Takashi Kido,
- Noriho Sakamoto,
- Naoki Hosogaya,
- Shogo Akabame,
- Takashi Sugimoto,
- Hirotomo Yamanashi,
- Kosuke Matsui,
- Mai Izumida,
- Ayumi Fujita,
- Masato Tashiro,
- Takeshi Tanaka,
- Koya Ariyoshi,
- Akitsugu Furumoto,
- Kouichi Morita,
- Koichi Izumikawa,
- Katsunori Yanagihara,
- Hiroshi Mukae
Affiliations
- Yasuhiro Tanaka
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
- Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Shimpei Morimoto
- Clinical Research Center, Nagasaki University Hospital, Nagasaki 852-8102, Japan
- Takeshi Nabeshima
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
- Kayoko Matsushima
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Hiroshi Ishimoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Nobuyuki Ashizawa
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Tatsuro Hirayama
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Kazuaki Takeda
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Hiroshi Gyotoku
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Naoki Iwanaga
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Shinnosuke Takemoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Susumu Fukahori
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Hiroyuki Yamaguchi
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Takashi Kido
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Noriho Sakamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Naoki Hosogaya
- Clinical Research Center, Nagasaki University Hospital, Nagasaki 852-8102, Japan
- Shogo Akabame
- Department of General Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Takashi Sugimoto
- Department of General Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Hirotomo Yamanashi
- Department of General Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Kosuke Matsui
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki 852-8523, Japan
- Mai Izumida
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki 852-8523, Japan
- Ayumi Fujita
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Masato Tashiro
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Takeshi Tanaka
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Koya Ariyoshi
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki 852-8523, Japan
- Akitsugu Furumoto
- Infectious Diseases Experts Training Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Kouichi Morita
- Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan
- Koichi Izumikawa
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki 852-8501, Japan
- Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
- DOI
- https://doi.org/10.3390/jcm11185444
- Journal volume & issue
-
Vol. 11,
no. 18
p. 5444
Abstract
Managing mild illness in COVID-19 and predicting progression to severe disease are concerning issues. Here, we investigated the outcomes of Japanese patients with mild COVID-19, and identified triage risk factors for further hospitalization and emergency department (ED) visits at a single tertiary hospital. A triage checklist with 30 factors was used. Patients recommended for isolation were followed up for 10 days for subsequent ED visits or hospital admission. Overall, 338 patients (median age, 44.0; 45% women) visited the clinic 5.0 days (median) after symptom onset. Thirty-six patients were immediately hospitalized following triage; others were isolated. In total, 72 non-hospitalized patients visited the ED during their isolation, and 30 were hospitalized after evaluation for oxygen desaturation. The median ED visit and hospitalization durations after symptom onset were 5.0 and 8.0 days, respectively. The checklist factors associated with hospitalization during isolation were age > 50 years, body mass index > 25 kg/m2, hypertension, tachycardia with pulse rate > 100/min or blood pressure > 135 mmHg at triage, and >3-day delay in hospital visit after symptom onset. No patients died. Altogether, 80% of patients with mild COVID-19 could be safely isolated at home. Age, BMI, underlying hypertension, date after symptom onset, tachycardia, and systolic blood pressure at triage might be related to later hospitalization.
Keywords