Clinical Characteristics of Patients With Coronavirus Disease 2019 (COVID-19) Receiving Emergency Medical Services in King County, Washington

Yang, Bishan; Barnard, Leslie M.; Emert, Jamie M.; Drucker, Christopher; Schwarcz, Leilani; Counts, Catherine R.; Murphy, David L.; Guan, Sally; Kume, Kosuke; Rodriquez, Karen; Jacinto, Tracie Y.; May, Susanne; Sayre, Michael R.; Rea, Thomas D.

doi:10.1001/jamanetworkopen.2020.14549

Cited by 73 publications

(84 citation statements)

References 17 publications

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“…Presentation with altered mental status has also been reported in older COVID-19 patients presenting to emergency medical services. 6 Although we found that LTCF cases were less likely to be hospitalized, receive aggressive medical interventions, or develop complications of sepsis or acute renal failure, they progressed more rapidly to death after symptom onset, likely reflecting the frail, debilitated state of many LTCF residents who are near end-of-life and have a DNR/DNI or comfort care status.…”

Section: Discussionmentioning

confidence: 62%

COVID-19-Associated Deaths in San Francisco: the Important Role of Dementia and Atypical Presentations in Long-term Care Facilities

Louie

Scott

et al. 2020

J GEN INTERN MED

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BACKGROUND COVID-19 has caused significant mortality worldwide. 1 Within the USA, marked geographic differences in incidence, hospitalization, and death have been reported. 2 Better characterization of populations at increased risk for death from COVID-19 is needed, including from long-term care facilities (LTCF). We describe the demographic and clinical characteristics of the first 50 fatalities with COVID-19 in San Francisco. METHODS All San Francisco residents who die with laboratoryconfirmed COVID-19 infection are reported to the San Francisco Department of Public Health (SFDPH). We reviewed case report forms, medical records, and death certificate data for demographics, clinical presentation, and hospital course when applicable. Cause of death was not considered to be due to COVID-19 if not listed as the underlying cause of death on both the death certificate and medical record. These activities were public health surveillance, and not research; therefore, institutional review board review was not obtained.

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Section: Discussionmentioning

confidence: 62%

COVID-19-Associated Deaths in San Francisco: the Important Role of Dementia and Atypical Presentations in Long-term Care Facilities

Louie

Scott

et al. 2020

J GEN INTERN MED

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“…The first recognized case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection leading to coronavirus disease 2019 (COVID-19) in the USA occurred during late January 2020 in the state of Washington 1 . Our state was hit hard by the outbreak that followed, as hospitals and emergency medical services became overwhelmed by severely ill patients in the major health-care hubs 2 – 5 . We first had a sprint, from March through to May 2020 when elective procedures and in-person patient visits were halted to reduce the risk of viral transmission, conserve personal protective equipment (PPE) and make more health-care workers available for the enormous clinical impact of COVID-19.…”

mentioning

confidence: 99%

Impact of the COVID-19 pandemic on clinical research

Tuttle

2020

Nat Rev Nephrol

107

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“…Nonrespiratory clinical presentation of COVID-19 disease is increasingly being reported. 25 - 27 While several of these manifestations are primarily due to the viral infection, others are secondary to inflammatory or immunologic sequelae. 25 - 27 Previously published data in SOT recipients reported fever as the most common presenting symptom.…”

Section: Discussionmentioning

confidence: 99%

“… 25 - 27 While several of these manifestations are primarily due to the viral infection, others are secondary to inflammatory or immunologic sequelae. 25 - 27 Previously published data in SOT recipients reported fever as the most common presenting symptom. 8 - 11 Chaudhary et al 13 had 55% of SOT recipients with diarrhea on presentation, while 8.4% presented with altered mentation.…”

Section: Discussionmentioning

confidence: 99%

Managing COVID-19-positive Solid Organ Transplant Recipients in the Community: What a Community Healthcare Provider Needs to Know

Basu

Patzer

Hosein

et al. 2020

Transplantation Direct

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Background. The current surge of coronavirus 2019 (COVID-19) cases in certain parts of the country has burdened the healthcare system, limiting access to tertiary centers for many. As a result, COVID-19-positive Solid Organ Transplant (SOT) recipients are increasingly being managed by local healthcare providers. It is crucial for community providers to understand disease severity and know if COVID-19-impacted SOT recipients have a different clinical course compared with COVID-19-negative SOT recipients with a similar presentation. Methods. We conducted a retrospective analysis on SOT recipients suspected to have COVID-19 infection tested during March 14, 2020–April 30, 2020. Patients were followed from time of testing to May 31, 2020. Results. One hundred sixty SOT recipients underwent testing: 22 COVID-19 positive and 138 COVID-19 negative. COVID-19-positive patients were more likely to have rapid progression of symptoms (median 3 vs 6 d, P = 0.002), greater hospitalizations (78% vs 64%, P < 0.017), and need for intensive care unit care (45% vs 17%, P < 0.001) Severe COVID-19 infection was not observed in patients on Belatacept for immunosuppression (30% vs 87%,P = 0.001). COVID- 19 positive patients in the intensive care unit were more likely to have multifocal opacities on radiological imaging in comparison to those admitted to the medical floor (90% vs 11%). Survival probability was similar in both cohorts. Conclusion. COVID-19-infected SOT recipients have a propensity for rapid clinical decompensation. Local providers need to be work closely with transplant centers to appropriately triage and manage COVID-19 SOT recipients in the community.

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Clinical Characteristics of Patients With Coronavirus Disease 2019 (COVID-19) Receiving Emergency Medical Services in King County, Washington

Cited by 73 publications

References 17 publications

COVID-19-Associated Deaths in San Francisco: the Important Role of Dementia and Atypical Presentations in Long-term Care Facilities

COVID-19-Associated Deaths in San Francisco: the Important Role of Dementia and Atypical Presentations in Long-term Care Facilities

Impact of the COVID-19 pandemic on clinical research

Managing COVID-19-positive Solid Organ Transplant Recipients in the Community: What a Community Healthcare Provider Needs to Know

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