A G Buenen1,2, P C Wever3, D P Borst4, K A Slieker5. 1. Bernhoven, afd. Spoedeisende Hulp, Uden. 2. Contact: A. G. Buenen (n.buenen@bernhoven.nl). 3. Regionaal Laboratorium voor Medische Microbiologie en Infectiepreventie, 's-Hertogenbosch. 4. Bernhoven, afd. Acute Opname, Uden. 5. Bernhoven, afd. Interne Geneeskunde, Uden.
Abstract
OBJECTIVE: To describe disease presentation and clinical characteristics of patients with COVID-19 presenting to the Emergency Department (ED) of Bernhoven hospital in Uden, the Netherlands. DESIGN: Prospective, descriptive study. METHOD: The registry focused on atypical symptoms and co-infections. We hypothesized that patients older than 70 years more often have atypical symptoms. The number of co-infections is unknown. Therefore, we prospectively registered medical history, duration of symptoms, symptoms, temperature, lab results and co-infections of patients with confirmed COVID-19 in the period March 4-16th. RESULTS: The clinical characteristics of 107 patients were registered. The average age was 71 years and 41% was female. The median duration of symptoms was 5 days. 19% of patients had not been referred to pulmonary or internal medicine. Symptoms were fever (78%), respiratory complaints (78%), chest pain (28%), abdominal pain (13%), and diarrhea (34%). In 54% of the COVID-19 patients at the ED, the temperature was ≥ 38,0°C, CRP ≥ 50 in 51%, leucocytosis in 12% and elevated LD in 61%. Of 31 patients 24 (77%) had an absolute lymphopenia. Co-infections were seen in 16% of patients. The mortality in the ED was 2% and ICU-admission 5%. On March 25th, 2020 the overall mortality was 22% and ICU-admission 15%. CONCLUSION: We have seen patients with a very serious disease resulting in a high mortality and ICU-admission. Over 35% of patient did not have the typical symptoms of fever and respiratory complaints; atypical symptoms like chest pain, abdominal pain and diarrhea are frequently seen. There is no difference between patients over and under 70 years. COVID-19 patients can present with atypical symptoms, co-infections and distributed over various medical specialties.
OBJECTIVE: To describe disease presentation and clinical characteristics of patients with COVID-19 presenting to the Emergency Department (ED) of Bernhoven hospital in Uden, the Netherlands. DESIGN: Prospective, descriptive study. METHOD: The registry focused on atypical symptoms and co-infections. We hypothesized that patients older than 70 years more often have atypical symptoms. The number of co-infections is unknown. Therefore, we prospectively registered medical history, duration of symptoms, symptoms, temperature, lab results and co-infections of patients with confirmed COVID-19 in the period March 4-16th. RESULTS: The clinical characteristics of 107 patients were registered. The average age was 71 years and 41% was female. The median duration of symptoms was 5 days. 19% of patients had not been referred to pulmonary or internal medicine. Symptoms were fever (78%), respiratory complaints (78%), chest pain (28%), abdominal pain (13%), and diarrhea (34%). In 54% of the COVID-19patients at the ED, the temperature was ≥ 38,0°C, CRP ≥ 50 in 51%, leucocytosis in 12% and elevated LD in 61%. Of 31 patients 24 (77%) had an absolute lymphopenia. Co-infections were seen in 16% of patients. The mortality in the ED was 2% and ICU-admission 5%. On March 25th, 2020 the overall mortality was 22% and ICU-admission 15%. CONCLUSION: We have seen patients with a very serious disease resulting in a high mortality and ICU-admission. Over 35% of patient did not have the typical symptoms of fever and respiratory complaints; atypical symptoms like chest pain, abdominal pain and diarrhea are frequently seen. There is no difference between patients over and under 70 years. COVID-19patients can present with atypical symptoms, co-infections and distributed over various medical specialties.
Authors: Angela R Wateska; Mary Patricia Nowalk; Hawre Jalal; Chyongchiou J Lin; Lee H Harrison; William Schaffner; Richard K Zimmerman; Kenneth J Smith Journal: Vaccine Date: 2021-05-25 Impact factor: 4.169
Authors: Elske Sieswerda; Mark G J de Boer; Marc M J Bonten; Wim G Boersma; René E Jonkers; Roel M Aleva; Bart-Jan Kullberg; Jeroen A Schouten; Ewoudt M W van de Garde; Theo J Verheij; Menno M van der Eerden; Jan M Prins; W Joost Wiersinga Journal: Clin Microbiol Infect Date: 2020-10-01 Impact factor: 8.067