Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Clinical, Laboratory, and Radiological Features Indicative of Novel Coronavirus Disease (COVID-19) in Emergency Departments – A Multicentre Case-Control Study in Hong Kong

Rex Pui Kin Lam
* ,
Kevin Kei Ching Hung
ORCID logo ,
Eric Ho Yin Lau
,
Chun Tat Lui
,
Kin Ling Chan
,
Chin San Leung
,
Ion Wa Wong
,
Kin Wa Wong
,
Colin A. Graham
ORCID logo ,
Patrick Chiu Yat Woo
ORCID logo
Version 1 : Received: 16 May 2020 / Approved: 17 May 2020 / Online: 17 May 2020 (08:27:12 CEST)

A peer-reviewed article of this Preprint also exists.

Lam, R.P.K.; Hung, K.K.C.; Lau, E.H.Y.; Lui, C.T.; Chan, K.L.; Leung, C.S.; Wong, I.W.; Wong, K.W.; Graham, C.A.; Woo, P.C.Y. Clinical, Laboratory, and Radiological Features Indicative of Novel Coronavirus Disease (COVID‐19) in Emergency Departments: A Multicenter Case‐control Study in Hong Kong. Journal of the American College of Emergency Physicians Open 2020, 1, 597–608, doi:10.1002/emp2.12183. Lam, R.P.K.; Hung, K.K.C.; Lau, E.H.Y.; Lui, C.T.; Chan, K.L.; Leung, C.S.; Wong, I.W.; Wong, K.W.; Graham, C.A.; Woo, P.C.Y. Clinical, Laboratory, and Radiological Features Indicative of Novel Coronavirus Disease (COVID‐19) in Emergency Departments: A Multicenter Case‐control Study in Hong Kong. Journal of the American College of Emergency Physicians Open 2020, 1, 597–608, doi:10.1002/emp2.12183.

Abstract

(1) Background: It is unclear whether the reported presenting clinical features of coronavirus disease 2019 (COVID-19) are useful in identifying high-risk patients for early testing and isolation in the emergency department (ED). We aimed to compare the exposure history, clinical, laboratory, and radiographic features of ED patients who tested positive and negative for COVID-19; (2) Methods: We conducted a case-control study in seven EDs during the first five weeks of the COVID-19 outbreak in Hong Kong. Thirty-seven laboratory-confirmed COVID-19 patients were compared with 111 age- and gender-matched controls; (3) Results: There were no significant differences in patient characteristics and reported symptoms between the groups, except patient-reported fever. A positive travel history or contact history was the most significant predictor for COVID-19 infection. After adjustment for age and presumed location of acquiring the infection in Wuhan/Hubei, patient-reported fever (OR 2.6, 95% CI 1.1 to 6.3), delayed presentation (OR 5.0, 95% CI 2.0 to 12.5), having medical consultation before ED presentation (OR 7.4, 95% 2.9 to19.1), thrombocytopenia (OR 4.0, 95% CI 1.6 to 9.7), raised lactate dehydrogenase (OR 5.9, 95% CI 1.9 to 18.5), haziness, consolidation or ground-glass opacity on chest radiography (OR 5.6, 95% CI 2.0 to 16.0), and bilateral changes on chest radiography (OR 13.2, 95% CI 4.7 to 37.4) were associated with a higher odds of COVID-19 separately while neutrophilia was associated with a lower odds (OR 0.3, 95% CI 0.1-0.8); and (4) Conclusions: This study highlights several features that may be useful in identifying high-risk patients for early testing and isolation while waiting for test result. Further studies are warranted to verify the findings.

Keywords

COVID-19; SARS-CoV-2; emergency department; early diagnosis; case-control studies

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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