Article Instance

HTTP 200 OK
Allow: GET
Content-Type: application/json
Vary: Accept

{
    "pk": 14377,
    "title": "Rate of Decompensation of Normoxic Emergency Department Patients with SARS-CoV-2",
    "subtitle": null,
    "abstract": "Introduction:\n As of October 30, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 44 million people worldwide and killed over 1.1 million people. In the emergency department (ED), patients who need supplemental oxygen or respiratory support are admitted to the hospital, but the course of normoxic patients with SARS-CoV-2 infection is unknown. In our health system, the policy during the coronavirus 2019 (COVID-19) pandemic was to admit all patients with abnormal chest imaging (CXR) regardless of their oxygen level. We also admitted febrile patients with respiratory complaints who resided in congregate living. We describe the rate of decompensation among patients admitted with suspected SARS-CoV-2 infection but who were not hypoxemic in the ED.\nMethods:\n This is a retrospective observational study of patients admitted to our health system between March 1–May 5, 2020 with suspected SARS-CoV-2 infection. We queried our registry to find patients who were admitted to the hospital but had no recorded oxygen saturation of <92% in the ED and received no supplemental oxygen prior to admission. Our primary outcome was decompensation at 72 hours, defined by the need for respiratory support (oxygen, high-flow nasal cannula, non-invasive ventilation, or intubation).\nResults:\n A total of 840 patients met our inclusion criteria. Of those patients, 376 (45%) tested positive for SARS-CoV-2. Sixty patients (7.1%) with suspected COVID-19 required respiratory support at 72 hours including 27 (3%) of confirmed SARS-CoV-2 positive patients. Among the 376 patients who tested positive for SARS-CoV-2, 54 patients (14%) had normal CXR in the ED. One-third of patients with normal CXRs decompensated at 72 hours. Seven SARS-CoV-2 positive patients in our cohort died during their hospitalization, of whom five had normal CXRs on admission.\nConclusion: \nSixty (7.1%) of suspected COVID-19 patients hospitalized at 72 hours required respiratory support despite being normoxic in the ED. Further research should look to identify the normoxic SARS-CoV-2 patients at risk for decompensation.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "coronovirus, pandemic, SARS, infectious disease"
        }
    ],
    "section": "Endemic Infections",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6377m55b",
    "frozenauthors": [
        {
            "first_name": "Kraftin",
            "middle_name": "E.",
            "last_name": "Schreyer",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Derek",
            "middle_name": "L.",
            "last_name": "Isenberg",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Wayne",
            "middle_name": "A.",
            "last_name": "Satz",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Nicole",
            "middle_name": "V.",
            "last_name": "Lucas",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Jennifer",
            "middle_name": "",
            "last_name": "Rosenbaum",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Gregory",
            "middle_name": "",
            "last_name": "Zandrow",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Nina",
            "middle_name": "T.",
            "last_name": "Gentle",
            "name_suffix": "",
            "institution": "Lewis Katz School of Medicine at Temple University, Department of Emergency Medicine, Philadelphia, Pennsylvania",
            "department": "None"
        }
    ],
    "date_submitted": "2020-07-22T07:34:15+05:30",
    "date_accepted": "2020-07-22T07:34:15+05:30",
    "date_published": "2021-04-02T22:43:29+05:30",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14377/galley/7381/download/"
        }
    ]
}