Factors associated with SARS‐CoV‐2 infection in patients attending an acute hospital ambulatory assessment unit. Issue 7 (6th April 2021) - Ronan, Geoffrey
Abstract: To describe the factors associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in mild‐to‐moderate patients attending for assessment. This observational study was conducted in a Model 4 tertiary referral center in Ireland. All patients referred for SARS‐CoV‐2 assessment over a 4‐week period were included. Patient demographics, presenting symptoms, comorbidities, medications, and outcomes (including length of stay, discharge, and mortality) were collected. Two hundred and seventy‐nine patients were assessed. These patients were predominantly female (62%) with a median age of 50 years ( SD 16.9). Nineteen (6.8%) patients had SARS‐CoV‐2 detected. Dysgeusia was associated with a 16‐fold increased prediction of SARS‐CoV‐2 positivity ( p = .001; OR, 16.8; 95% CI, 3.82–73.84). Thirteen patients with SARS‐COV‐2 detected (68.4%) were admitted, in contrast with 38.1% (99/260) of patients with SARS‐CoV‐2 non‐detectable or not tested ( p = .001). Female patients were more likely to be hospitalized ( p = .01) as were current and ex‐smokers ( p = .05). We describe olfactory disturbance and fever as the main presenting features in SARS‐CoV‐2 infection. These patients are more likely to be hospitalized with increased length of stay; however, they make up a minority of the patients assessed. "Non‐detectable" patients remain likely to require prolonged hospitalization. Knowledge of predictors of hospitalization in a "non‐detectable" cohort will aid future planning and discussion of patient assessment in a SARS‐CoV‐2 era. Highlights: Mild‐to‐moderate patients with SARs‐CoV‐2 infection tend to present with characteristic olfactory disturbance. From a medical assessment standpoint; patients with mild‐to‐moderate symptoms that are PCR negative remain likely to require hospitalization. Mild‐to‐moderate patients with positive PCR testing are more likely to be admitted and require longer lengths of stay.