COVID-19 emergency department discharges: an outcome study
Open accessAbstract
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.
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In COVID-19 follow-up clinics, a high proportion of patients reported disproportionate breathlessness, alongside symptoms of fatigue and decreased exercise tolerance.
“In COVID- 19 follow- up clinics, a high proportion of patients reported of disproportionate breathlessness, alongside symptoms of fatigue and decreased exercise tolerance.”
From Physiotherapy assessment of breathing pattern disorder: a qualitative evaluation (2023) · cites this paper as [10]
The Findings in the 6-week follow-up clinic report persistent breathlessness in 43% of patients and severe fatigue in 29%. The Discussion says breathlessness was often unexplained by imaging, supporting the description of disproportionate breathlessness. The paper discusses exercise testing and rehabilitation needs, but does not report decreased exercise tolerance as a patient-reported symptom. (LLM, conf=0.84)
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References 12 · Cited by 14
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- Authors
- Lanham, D., Roe, J., Chauhan, A., Evans, R., Hillman, T., Logan, S., & Heightman, M.
- Affiliations
- University College London Hospitals NHS Foundation Trust (GB)
- Venue
- Clinical Medicine
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 21
- Issue
- 2
- Pages
- e126-e131
- ISSN
- 1470-2118 (ISSN-L)
- PMC
- PMC8002789
- OpenAlex
- W3120553515
- Cited by
- 14
- References
- 12
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 1
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Medicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Oncology › COVID-19 and healthcare impacts
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- COVID-19 pandemic, emergency department discharge, safety netting, post-discharge follow-up, clinical deterioration, emergency department overcrowding, follow-up clinic, telephone follow-up, hospital readmission
- MeSH terms
- COVID-19, SARS-CoV-2, Emergency Service, Hospital, Follow-Up Studies, Humans, London, Patient Discharge, Outcome Assessment, Health Care
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