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Biological markers and follow-up after discharge home of patients with COVID-19 pneumonia

Gutiérrez Gabriel S, Domínguez García MJ, Pérez Mañas G, Moreno García N, Silvan Domínguez M, Andrés EM

Servicio de Urgencias, Hospital Universitario de Fuenlabrada, Madrid, Spain. Medicina Familiar y Comunitaria, Hospital Universitario de Fuenlabrada, Madrid, Spain. Grupo “gestión del paciente sangrante” idiPaz-Hospital Universitario La Paz, Madrid, Spain. Universidad Rey Juan Carlos, Madrid, Spain.

Background and objective. We aimed to analyze the clinical course of patients discharged from our emergency departament (ED) with pneumonia symptoms compatible with a diagnosis of COVID-19.
Methods. We followed 102 patients discharged home with a diagnosis of pneumonia compatible with COVID19 between March 12 and 21, 2020, in our hospital in the southern part of the autonomous community of Madrid. Descriptive statistics (medians and interquartile ranges or frequencies, as appropriate) were compiled for the main variables. Treatments and prognoses were compared with c2, Kruskal–Wallis, or Mann–Whitney tests. The data then underwent logistic regression analysis.
Results. Most patients (accounting for 74.5% of the discharges) were treated with hydroxychloroquine alone. The readmission rate was 15.7%; the ED revisiting rate was 25.7%. Admission was associated with an elevated lactate dehydrogenase (LDH) level (P=.011), elevated creatine kinase (CK) (P=.004), and lymphopenia (P=.034). Hypertension and chronic obstructive pulmonary disease were also related to admission. Ischemic heart disease was associated with longer duration of symptoms.
Conclusions. Lymphopenia, and elevated LDH and CK levels predicted the need for hospital admission better than other traditional biological markers in patients with mild to moderate symptoms. Telephone follow-up proved useful for dealing with the overloading of health care services.

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