Assessment of patients with acute respiratory symptoms during the COVID-19 pandemic by Telemedicine: clinical features and impact on referral.

Autor: Accorsi TAD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Amicis K; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Brígido ARD; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Belfort DSP; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Habrum FC; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Scarpanti FG; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Magalhães IR; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Silva Filho JRO; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Sampaio LPC; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Lira MTSS; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Morbeck RA; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Pedrotti CHS; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil., Cordioli E; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Jazyk: English; Portuguese
Zdroj: Einstein (Sao Paulo, Brazil) [Einstein (Sao Paulo)] 2020 Dec 07; Vol. 18, pp. eAO6106. Date of Electronic Publication: 2020 Dec 07 (Print Publication: 2020).
DOI: 10.31744/einstein_journal/2020AO6106
Abstrakt: Objective: To characterize variables associated with referral to the emergency department following Telemedicine consultation during the COVID-19 pandemic.
Methods: Cross-sectional retrospective study conducted between March and May 2020, with a sample of 500 adult patients. The inclusion criterion was the manifestation of respiratory symptoms, regardless of type.
Results: The mean age of patients was 34.7±10.5 years, and 59% were women. Most patients (62.6%) perceived their own health status as malaise and some (41.4%) self-diagnosed COVID-19. Cough (74.4%), rhinorrhea (65.6%), sore throat (38.6%) and sneezing (20.6%) were the most common infection-related symptoms. Overall, 29.4% and 16% of patients reported dyspnea and chest pain, respectively. The Roth score was calculated for a sizeable number of patients (67.6%) and was normal, moderately altered or severely altered in 83.5%, 10.7% and 5.6% of patients, respectively. The percentage of suspected COVID-19 cases was 67.6%. Of these, 75% were managed remotely and only one quarter referred for emergency assessment.
Conclusion: Telemedicine assessment is associated with reclassification of patient's subjective impression, better inspection of coronavirus disease 2019 and identification of risk patients. Referral is therefore optimized to avoid inappropriate in-person assessment, and low-risk patients can be properly guided. Telemedicine should be implemented in the health care system as a cost-effective strategy for initial assessment of acute patients.
Databáze: MEDLINE
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