Buenen A G, Wever P C, Borst D P, Slieker K A
Bernhoven, afd. Spoedeisende Hulp, Uden.
Contact: A. G. Buenen (
Ned Tijdschr Geneeskd. 2020 Apr 2;164:D5001.
To describe disease presentation and clinical characteristics of patients with COVID-19 presenting to the Emergency Department (ED) of Bernhoven hospital in Uden, the Netherlands.
Prospective, descriptive study.
The registry focused on atypical symptoms and co-infections. We hypothesized that patients older than 70 years more often have atypical symptoms. The number of co-infections is unknown. Therefore, we prospectively registered medical history, duration of symptoms, symptoms, temperature, lab results and co-infections of patients with confirmed COVID-19 in the period March 4-16th.
The clinical characteristics of 107 patients were registered. The average age was 71 years and 41% was female. The median duration of symptoms was 5 days. 19% of patients had not been referred to pulmonary or internal medicine. Symptoms were fever (78%), respiratory complaints (78%), chest pain (28%), abdominal pain (13%), and diarrhea (34%). In 54% of the COVID-19 patients at the ED, the temperature was ≥ 38,0°C, CRP ≥ 50 in 51%, leucocytosis in 12% and elevated LD in 61%. Of 31 patients 24 (77%) had an absolute lymphopenia. Co-infections were seen in 16% of patients. The mortality in the ED was 2% and ICU-admission 5%. On March 25th, 2020 the overall mortality was 22% and ICU-admission 15%.
We have seen patients with a very serious disease resulting in a high mortality and ICU-admission. Over 35% of patient did not have the typical symptoms of fever and respiratory complaints; atypical symptoms like chest pain, abdominal pain and diarrhea are frequently seen. There is no difference between patients over and under 70 years. COVID-19 patients can present with atypical symptoms, co-infections and distributed over various medical specialties.
描述在荷兰乌登的伯恩霍芬医院急诊科就诊的新冠肺炎患者的疾病表现和临床特征。
前瞻性描述性研究。
该登记研究聚焦于非典型症状和合并感染。我们假设70岁以上的患者更常出现非典型症状。合并感染的数量未知。因此，我们前瞻性地记录了2020年3月4日至16日期间确诊新冠肺炎患者的病史、症状持续时间、症状、体温、实验室检查结果和合并感染情况。
记录了107例患者的临床特征。平均年龄为71岁，41%为女性。症状的中位持续时间为5天。19%的患者未被转诊至肺病科或内科。症状包括发热（78%）、呼吸道症状（78%）、胸痛（28%）、腹痛（13%）和腹泻（34%）。在急诊科的新冠肺炎患者中，54%的患者体温≥38.0°C，51%的患者C反应蛋白≥50，12%的患者白细胞增多，61%的患者乳酸脱氢酶升高。在31例患者中，24例（77%）有绝对淋巴细胞减少。16%的患者有合并感染。急诊科的死亡率为2%，入住重症监护病房的比例为5%。2020年3月25日，总体死亡率为22%，入住重症监护病房的比例为15%。
我们观察到患者所患疾病非常严重，导致高死亡率和高入住重症监护病房率。超过35%的患者没有发热和呼吸道症状等典型症状；胸痛、腹痛和腹泻等非典型症状很常见。70岁以上和70岁以下的患者之间没有差异。新冠肺炎患者可能表现为非典型症状、合并感染，且分布于各个医学专科。
