University College London Hospitals NHS Foundation Trust, London, UK
University College London Hospitals NHS Foundation Trust, London, UK.
Clin Med (Lond). 2021 Mar;21(2):e126-e131. doi: 10.7861/clinmed.2020-0817. Epub 2021 Jan 8.
Pressure on acute medical services in the pandemic mandated an assertive emergency department (ED) discharge policy. Given the potential for subsequent deterioration and growing appreciation of complications relating to COVID-19 infection, this follow up study was instigated to provide clinical reassurance that discharged patients had followed a safe clinical course. 199 patients discharged from the ED of our central London hospital were identified over a 20-day period at the height of the pandemic in April 2020. 44 had already reattended ED and 12 had been admitted. At 2-week telephone follow-up, 14 patients were identified who required urgent recall for assessment. At 4-week telephone follow-up, 87 patients were identified with persistent symptoms requiring face to face review. A COVID-19 follow-up clinic was therefore established to provide multi-professional review and diagnostics. 65 patients attended for this assessment. This is the first report on outcomes in COVID-19 infected patients discharged from an ED. It highlights the importance of safety-netting after discharge, the difficulty in predicting which patients might deteriorate and the need for appropriate follow up services.
在大流行期间，急性医疗服务的压力要求采取果断的急诊（ED）出院政策。鉴于 COVID-19 感染相关并发症的潜在恶化和日益认识，因此进行了这项随访研究，以提供临床保证，即出院患者已经经历了安全的临床过程。在 2020 年 4 月大流行高峰期的 20 天内，从我们伦敦市中心医院的 ED 出院的 199 名患者被确定。其中 44 名已经重新就诊 ED，12 名已经入院。在 2 周的电话随访中，确定了 14 名需要紧急召回评估的患者。在 4 周的电话随访中，确定了 87 名有持续症状需要面对面复查的患者。因此，建立了 COVID-19 随访诊所，以提供多专业评估和诊断。65 名患者接受了评估。这是第一篇关于从 ED 出院的 COVID-19 感染患者结局的报告。它强调了出院后安全网的重要性，预测哪些患者可能恶化的困难，以及需要适当的随访服务。
