Separating the Wheat From the Chaff – Covid-19 in a German Emergency Department: A Case-control Study

Fistera, David; Pabst, Dirk; Härtl, Annalena; Schaarschmidt, Benedikt Michael; Umutlu, Lale; Dolff, Sebastian; Holzner, Carola; Kill, Clemens; Risse, Joachim

doi:10.21203/rs.3.rs-37052/v1

Cited by 8 publications

(15 citation statements)

References 16 publications

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“…In total, 241 were included in the present systematic review and meta-analysis (Gamper et al, 2012; Liu et al, 2016; Adamczyk et al, 2020; Adedeji et al, 2020; Adorni et al, 2020; Aggarwal et al, 2020; Al-Ani and Acharya, 2020; Altin et al, 2020; Andrews et al, 2020; Anna et al, 2020; Asai et al, 2020; Bastiani et al, 2020; Beltran-Corbellini et al, 2020; Bergquist et al, 2020; Biadsee et al, 2020; Bidkar et al, 2020b; Boscolo-Rizzo et al, 2020a, 2020b, 2020c, 2021; Boudjema et al, 2020; Brandao Neto et al, 2020; Bulgurcu et al, 2020; Calica Utku et al, 2020; Carignan et al, 2020; Chary et al, 2020; Chen et al, 2020; Chiesa-Estomba et al, 2020; Cho et al, 2020; Chung et al, 2020; Cocco et al, 2020; Dawson et al, 2020; Dell’Era et al, 2020; De Maria et al, 2020; Durrani et al, 2020; Elimian et al, 2020; Farah Yusuf Mohamud et al, 2020; Fistera et al, 2020; Fontanet et al, 2020; Freni et al, 2020; Garg et al, 2020; Gelardi et al, 2020; Giacomelli et al, 2020; Gorzkowski et al, 2020; Gozen et al, 2020; GÜner et al, 2020; Gudbjartsson et al, 2020; Guillen Martinez et al, 2020; Haehner et al, 2020; Hintschich et al, 2020b; Horvath et al, 2020; Iversen et al, 2020; Izquierdo-Domínguez et al, 2020; Jain et al, 2020; Jalessi et al, 2020; Kacem et al, 2020; Karadas et al, 2020; Kempker et al, 2020; Kim et al, 2020; Klopfenstein et al, 2020; Konstantinidis et al, 2020; Krishnasamy et al, 2020; Kronborg et al, 2020; Kumar et al, 2020, 2021a, 2021b; Lagi et al, 2020; Lan et al, 2020; Lapostolle et al, 2020; …”

Section: Included Articlesmentioning

confidence: 99%

Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis

Hannum

Koch

Ramirez

et al. 2021

Preprint

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Chemosensory scientists have been skeptical that reports of COVID–19 taste loss are genuine, in part because, before COVID–19, taste loss was rare and often confused with smell loss. Therefore, to establish the predicted prevalence rate of taste loss in COVID–19 patients, we conducted a systematic review and meta–analysis of 376 papers published in 2020 and 2021, with 241 of the papers meeting all inclusion criteria. Additionally, we explored how methodological differences (direct vs. self-report measures) may affect these estimates. We hypothesized that direct prevalence measures of taste loss would be the most valid because they avoid the taste/smell confusion of self-report. The meta–analysis showed that, among 138,897 COVID–19–positive patients, 39.2% reported taste dysfunction (95% CI: 35.34–43.12%), and the prevalence estimates were slightly but not significantly higher from studies using direct (n = 18) versus self-report (n = 223) methodologies (Q = 0.57, df = 1, p = 0.45). Generally, males reported lower rates of taste loss than did females and taste loss was highest in middle-aged groups. Thus, taste loss is a bona fide symptom COVID–19, meriting further research into the most appropriate direct methods to measure it and its underlying mechanisms.

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Section: Included Articlesmentioning

confidence: 99%

Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis

Hannum

Koch

Ramirez

et al. 2021

Preprint

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“…The study was conducted following a similar protocol as a previous one [13], so patients and methods show some overlap.…”

Section: Methodsmentioning

confidence: 99%

What about the others: differential diagnosis of COVID-19 in a German emergency department

et al. 2021

Self Cite

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Background The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging. Method We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs. Results Among the 267 COVID-19 negative patients, 42.7% had respiratory, 14.2% had other infectious, and 11.2% had cardiovascular diseases. Further, 9.0% and 6.7% had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs. 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014). Conclusion For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections. Trial registration: German Clinical Trial Registry DRKS, DRKS-ID of the study: DRKS00021675 date of registration: May 8th, 2020, retrospectively registered.

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“…Eine Differenzialdiagnostik ist klinisch nicht sicher möglich 13 , daher ist eine frühestmögliche Testung anzustreben. In beiden Notaufnahmen unseres Klinikums wurde bereits zu Beginn der Pandemie ein PCR-Schnelltest etabliert, der binnen 40 Minuten ein valides Ergebnis liefert.…”

Section: Diskussionunclassified

Wellenreiten – 12 Monate COVID-19 im Maximalversorger

Fistera

Pabst²,

Falk³

et al. 2021

Dtsch Med Wochenschr

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Zusammenfassung Einleitung Mit weit mehr als 1400 stationär behandelten COVID-19-Patienten ist die Universitätsmedizin Essen der größte COVID-19-Versorger der Region Rhein-Ruhr. Wir präsentieren die Daten unserer Patienten aus den ersten 12 Monaten der Pandemie und die hieraus entstandenen praktischen Konzepte. Methode Retrospektive Analyse aller 1396 stationären COVID-19-Patienten, die zwischen dem 1. März 2020 und 28. Februar 2021 versorgt wurden, im Hinblick auf Komorbiditäten, Überleben und Komplikationen im Verlauf. Es erfolgte ein Gruppenvergleich zwischen Patienten auf Normalstation und Überwachungs-/ Intensivstation. Ergebnisse Bei einer Gesamtmortalität von 19,8 % (277/1396) starben 10,6 % (93/877) der Patienten auf Normalstation und 35,5 % (184/519) der Patienten auf Intensiv- und Überwachungsstationen im klinischen Verlauf. Hierbei waren ein Alter über 60 Jahre, Adipositas, maschinelle Beatmung, NO-Therapie, ECMO-Therapie sowie akutes Nierenversagen und Apoplex im Therapieverlauf unabhängige Prädiktoren für Mortalität. Fazit Die Mortalität unseres Kollektivs auf Normal- bzw. Intensivstationen liegt im Rahmen international publizierter Daten. Sowohl die hohe Rate von Komplikationen bei schwerem Verlauf als auch die große Bedeutung einfacher Komorbiditäten kann eindrücklich gezeigt werden. Das mittlere Alter der Patienten ist mit 60 Jahren auf Normalstation und 63 Jahren auf Intensivstationen überraschend niedrig. Maximaler Patienten- und Personalschutz, eine rasche und effektive Teststrategie im Rahmen der primären Triage, standardisierte Abläufe von der Notaufnahme bis zur Intensivstation sowie eine dynamische tagesaktuelle Anpassung der Ressourcen können eine hohe Versorgungsqualität, auch während der Pandemie, sichern.

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Separating the Wheat From the Chaff – Covid-19 in a German Emergency Department: A Case-control Study

Cited by 8 publications

References 16 publications

Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis

Taste loss as a distinct symptom of COVID-19: A systematic review and meta-analysis

What about the others: differential diagnosis of COVID-19 in a German emergency department

Wellenreiten – 12 Monate COVID-19 im Maximalversorger

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