Clinical, laboratory, and radiological features indicative of novel coronavirus disease (COVID‐19) in emergency departments: a multicenter case‐control study in Hong Kong

Abstract

Objectives Little is known about the value of routine clinical assessment in identifying patients with coronavirus disease 2019 (COVID‐19) in the emergency department (ED). We aimed to compare the exposure history, signs and symptoms, laboratory, and radiographic features of ED patients who tested positive and negative for COVID‐19. Methods This was a case‐control study in 7 EDs in Hong Kong from 20 January to 29 February 2020. Thirty‐seven patients with laboratory‐confirmed COVID‐19 were age‐ and sex‐matched to 111 controls. We compared the groups with univariate analysis and calculated the odds ratio (OR) of having COVID‐19 for each characteristic that was significantly different between the groups with adjustment for age and presumed location of acquiring the infection. Results There were no significant differences in patient characteristics and reported symptoms between the groups. A positive contact history within 14 days (adjusted OR 37.61, 95% CI: 10.86–130.19), bilateral chest radiograph shadow (adjusted OR 13.19, 95% CI: 4.66–37.35), having prior medical consultation (adjusted OR 7.43, 95% 2.89–19.09), a lower white blood cell count (adjusted OR 1.30, 95% CI: 1.11–1.51), and a lower platelet count (adjusted OR 1.07, 95% CI: 1.01–1.12) were associated with a higher odds of COVID‐19 separately. A higher neutrophil count was associated with a lower odds of COVID‐19 (adjusted OR 0.77, 95% CI: 0.65–0.91). Conclusion This study highlights a number of clinical features that may be useful in identifying high‐risk patients for early testing and isolation while waiting for the test result. Further studies are warranted to verify the findings.

Global prevalence and pathogenesis of headache in COVID-19: A systematic review and meta-analysis

“…The rest of the references had been excluded for these reasons: (a) the studies were case reports or case-series (n=98); (b) the full-text did not include data of outcome of interest (n=84); and (c) low quality of study (n=3) ( Figure 1 ). The included studies were conducted in a wide ranges of regions: Australia 127 , Belgium 29 , Brazil 50 , China 70 , France 99 , Hongkong 128 , Israel 129 , Italy 130 , Germany 131 , Netherlands 31 , Turkey 120 , and the US 28 , 105 , 122 , 132 , 133 . Out of the studies, ten were case-control 28 , 29 , 31 , 99 , 105 , 120 , 128 , 130 , 132 , four were cross-sectional 50 , 70 , 122 , 131 , 133 , and two were prospective cohort studies 127 , 129 .…”

The chronicles of COVID

“…This brief commentary is intended to accompany the journal's podcast on several articles. [1][2][3][4][5][6][7][8][9] The 2019 novel coronavirus (COVID-19) has occupied most of our personal and professional lives this year. This August edition of the journal has 9 contributions about the pandemic and our colleagues' Collectively, the 9 articles in the August edition of JACEP Open provide a broad description of both the COVID epidemiology and the health care response.…”

“…This pandemic is truly global, as is the response. In “Bracing for Impact: Operational Upshots From the National Centre for Infectious Diseases Screening Centre (Singapore) During the COVID‐19 Outbreak,” Manauis et al 6 describe a fascinating approach to limit community spread of the virus in Singapore. Based on their experiences with SARS in 2003 and H1N1 in 2009, they built the National Center for Infectious Diseases, which includes a large screening center.…”