Nazli Gormeli Kurt1, Celal Gunes2. 1. Department of Emergency Medicine, Ankara City Hospital, 06800, Ankara, Turkey. 2. Batman State Hospital, Batman, Turkey.
Abstract
OBJECTIVE: In the present study we aimed to investigate the clinical and demographic characteristics of asymptomatic COVID-19 cases incidentally diagnosed at the emergency department. METHODOLOGY: This study retrospectively analyzed the medical data of patients who presented to emergency department, between March 1 - May 1, 2020, without COVID-19 symptoms such as fever, cough, myalgia on admission but were incidentally detected to have thoracic computerized tomography (CT) findings suggestive of COVID-19. The patients' sociodemographic and epidemiological characteristics, laboratory test results, clinical and radiological findings, treatment protocols, and prognoses were recorded. RESULTS: We incidentally diagnosed COVID-19 pneumonia in 81 asymptomatic patients. All patients presented to emergency department with traumatic injuries. Of these, 38 (46%) were injured in in-vehicle traffic accidents; 27 (34%) out-of-vehicle traffic accidents; 14 (18%) simple falls; and 2 (2%) falls from a height. Only 42 (48%) patients had a history of suspected contact with a COVID-19 positive individual. The mean time to symptom onset of 81 patients was 5±2 days. An analysis based on thoracic computerized tomography findings showed that the common finding found in all patients was ground glass opacity (GGO). While 55 (68%) patients had GGO alone, 10 (12%) had additional fine reticulations; 6 (7%) had an additional halo sign; 6 (7%) had an additional air bronchogram; and 4 (5%) had an additional area of consolidation. None of the patients died during follow-up, and all of them were discharged. CONCLUSION: Early identification and isolation of asymptomatic patients is of great importance for reducing the speed of propagation of the COVID-19 pandemic. Incidentally diagnosed cases have made us to consider that there is a need to increase the number of screening tests. We also believe that healthcare staff should suspect COVID-19 pneumonia in every patient irrespective presentation type, place importance on the use of personal protective equipment (PPE), and not examine any patient without wearing PPE. This article is protected by copyright. All rights reserved.
OBJECTIVE: In the present study we aimed to investigate the clinical and demographic characteristics of asymptomatic COVID-19 cases incidentally diagnosed at the emergency department. METHODOLOGY: This study retrospectively analyzed the medical data of patients who presented to emergency department, between March 1 - May 1, 2020, without COVID-19 symptoms such as fever, cough, myalgia on admission but were incidentally detected to have thoracic computerized tomography (CT) findings suggestive of COVID-19. The patients' sociodemographic and epidemiological characteristics, laboratory test results, clinical and radiological findings, treatment protocols, and prognoses were recorded. RESULTS: We incidentally diagnosed COVID-19 pneumonia in 81 asymptomatic patients. All patients presented to emergency department with traumatic injuries. Of these, 38 (46%) were injured in in-vehicle traffic accidents; 27 (34%) out-of-vehicle traffic accidents; 14 (18%) simple falls; and 2 (2%) falls from a height. Only 42 (48%) patients had a history of suspected contact with a COVID-19 positive individual. The mean time to symptom onset of 81 patients was 5±2 days. An analysis based on thoracic computerized tomography findings showed that the common finding found in all patients was ground glass opacity (GGO). While 55 (68%) patients had GGO alone, 10 (12%) had additional fine reticulations; 6 (7%) had an additional halo sign; 6 (7%) had an additional air bronchogram; and 4 (5%) had an additional area of consolidation. None of the patients died during follow-up, and all of them were discharged. CONCLUSION: Early identification and isolation of asymptomatic patients is of great importance for reducing the speed of propagation of the COVID-19 pandemic. Incidentally diagnosed cases have made us to consider that there is a need to increase the number of screening tests. We also believe that healthcare staff should suspect COVID-19 pneumonia in every patient irrespective presentation type, place importance on the use of personal protective equipment (PPE), and not examine any patient without wearing PPE. This article is protected by copyright. All rights reserved.