Characteristics of a Cohort of Ambulatory Patients with SARS-CoV-2 Infection: Based on Hospital Records
https://orcid.org/0000-0002-0104-4107
Melissa Díaz Puentes
https://orcid.org/0000-0003-2297-1855
Juliana Villanueva Congote
https://orcid.org/0000-0002-0700-5686
Edwin Orlando Pulido
https://orcid.org/0000-0001-8207-0018
Peter Alfonso Olejua
https://orcid.org/0000-0002-2478-0908
Sandra Liliana Valderrama Beltrán
https://orcid.org/0000-0003-1833-1599
Claudio Villaquirán Torres
https://orcid.org/0000-0002-3743-6268
Carlos Andrés Celis Preciado
https://orcid.org/0000-0001-8405-4513
María Margarita Andrade
https://orcid.org/0000-0001-9441-4375
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Introduction: 80% of patients with SARS-CoV-2 that exhibit mild and moderate disease manifestations receive ambulatory treatment. This study describes the characteristics of a cohort of patients with SARS-CoV-2 infection treated in an ambulatory setting, contributing evidence that improves decision-making in clinical and public health settings. Materials and Methods: We conducted a single-cohort study in patients with SARS-CoV-2 infection who attended a high complexity hospital in Colombia from March 2020 to May 2021. A descriptive analysis of sociodemographic data, comorbidities, disease presentation, treatments, and radiological exams was performed. A sub-group analysis was also done of healthcare workers, pregnant women, people under age 18 and above age 60, and patients with readmissions to the institution. Results: A total of 3535 patients required treatment outside the hospital during the entire course of the disease. The most frequently reported symptoms were cough, 65.1%; headache, 47.3%; odynophagia, 45.8%; and fever, 35.7%. Time from symptom onset to the first consultation was 5.7 ± 4.4 days for older adults, 3.6 ± 3.6 days for children, 3.2 ± 3.3 days for healthcare workers, and 2.7 ± 1.9 for pregnant women. 157 patients (4.4%) were readmitted to the hospital within the subsequent seven days, and 2 of these patients died. Conclusions: Time from symptom onset to the first consultation was longer in older adults than in other groups, suggesting a need for adapting healthcare services to promote opportune consultation in this population.
1. World Health Organization. Clinical management of COVID-19 [Internet]; 2021. Available at: https://www.who.int/es/publications/i/item/WHO-2019-nCoV-clinical-2021-1
2. Lapostolle F, Schneider E, Vianu I, Dollet G, Roche B, Berdah J, et al. Clinical features of 1487 COVID-19 patients with outpatient management in the Greater Paris: the COVID-call study. Intern Emerg Med. 2020;15:813-7. https://doi.org/10.1007/s11739-020-02379-z
3. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. https://doi.org/10.1016/S0140-6736(20)30566-3
4. Sagar A, Gottridge JA, LaVine N. Practical tips for ambulatory care in COVID-19: lessons learned in a New York Health System. Am J Med Qual. 2021 Jan-Feb 01;36(1):1-4. https://doi.org/10.1177/1062860620954273
5. Ortiz-Brizuela E, Villanueva-Reza M, González-Lara MF, Tamez-Torres KM, Román-Montes CM, Díaz-Mejía BA, et al. Clinical and epidemiological characteristics of patients diagnosed with covid-19 in a tertiary care center in Mexico City: a prospective cohort study. Rev Invest Clin. 2020;72:165-77. https://doi.org/10.24875/RIC.20000334
6. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, et al. Risk factors for mortality in patients with COVID-19 in New York City. J Gen Intern Med. 2021 Jan;36(1):17-26. https://doi.org/10.1007/s11606-020-05983-z
7. Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo C-G, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Heal. 2020;5:e475-83.
8. Gómez-Ochoa SA, Franco OH, Rojas LZ, Raguindin PF, Roa-Díaz ZM, Wyssmann BM, et al. COVID-19 in health-care workers: a living systematic review and meta-analysis of prevalence, risk factors, clinical characteristics, and Outcomes. Am J Epidemiol. 2021;190:161-75.
9. Ministerio de Protección Social de Colombia, Humanos DGDAYPR. Composición de la oferta de profesionales de medicina en Colombia 2009. 2009;4.
10. Salud Data. COVID-19: trabajadores salud [Internet]. [Cited 2021 Jan 16]. Available at: https://saludata.saludcapital.gov.co/osb/index.php/datos-de-salud/salud-laboral/covid-19-trabajadores-salud/
11. Ariza B, Torres X, Salgado D, Cepeda M, Gómez Restrepo C, Castellanos JC, et al. Seroprevalence and seroconversion rates to SARS-CoV-2 in interns, residents, and medical doctors in a University Hospital in Bogotá, Colombia. Infectio. 2021;25:145. http://dx.doi.org/10.22354/in.v25i3.938
12. Waterfield T, Watson C, Moore R, Ferris K, Tonry C, Watt A, et al. Seroprevalence of SARS-CoV-2 antibodies in children: a prospective multicentre cohort study. Arch Dis Child. 2021 Jul;106(7):680-686. https://doi.org/10.1136/archdischild-2020-320558
13. Steinman MA, Perry L, Perissinotto CM. Meeting the care needs of older adults isolated at home during the COVID-19 pandemic. JAMA Intern Med. 2020;180(6):819.
14. Gerst-Emerson K, Jayawardhana J. Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults. Am J Public Health. 2015;105:1013-9. https://doi.org/10.2105/AJPH.2014.302427
15. Stephanie S, Shum T, Cleveland H, Challa SR, Herring A, Jacobson FL, et al. Determinants of Chest X-Ray Sensitivity for COVID- 19: a multi-institutional study in the United States. Radiol Cardiothorac Imaging. 2020;2:e200337.
16. Cozzi A, Schiaffino S, Arpaia F, Della G, Tritella S, Bertolotti P, et al. Chest x-ray in the COVID-19 pandemic: Radiologists’ real-world reader performance. 2020;132:1-8.
17. Gupta RK, Marks M, Samuels THA, Luintel A, Rampling T, Chowdhury H, et al. Systematic evaluation and external validation of 22 prognostic models among hospitalised adults with COVID-19: an observational cohort study. Eur Respir J. 2020;56:2003498.
18. Hilarión-Gaitán L, Díaz-Jiménez D, Cotes-Cantillo K, Castañeda-Orjuela C. Desigualdades en salud según régimen de afiliación y eventos notificados al Sistema de Vigilancia (Sivigila) en Colombia, 2015. Biomédica. 2019;39:737-47. https://doi.org/10.7705/biomedica.4453
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