Pathway of Suspected-COVID-19 Patients From French Emergency Departments During The First Outbreak: A Prospective Controlled Cohort Study

Abstract Background To describe the clinical characteristics, management, and outcome of patients admitted in French emergency departments (EDs) for COVID-19 suspicion. Methods A prospective, multicenter, observational study was conducted in 4 EDs. Adult patients (≥18 years) admitted in EDs between March 6, 2020 and May 10, 2020, hospitalized, and who were presenting symptoms evocative of COVID-19 were included. The clinical features, management, and prognosis of patients was compared according to their confirmed COVID-19 status. Results A total of 2,686 patients were included, among them 760 (28.3%) were COVID-19 positive. Among the latter, the mean ± SD age was 71.5 ± 16.5 years. A total of 364 (48.0%) positive patients had hypertension, 228 (30.0%) had chronic cardiac disease, 186 (24.5%) had diabetes, 126 (16.6%) were obese, and 114 (15.0%) had chronic respiratory disease. The proportion of patients admitted in intensive care units (ICU) was higher among COVID-19 positive patients (185, 24.3%) compared to COVID-19 negative patients (206, 10.7%; p<0.001) and they required mechanical ventilation more frequently (89, 11.9% vs 37, 1.9%; p<0.001). The median [IQR] length of hospital stay was longer among COVID-19-positive patients (10 [6-15] vs 6 [2-11] days; p<0.001). The in-hospital mortality was significantly higher among COVID-19 positive patients (139, 18.3% vs 149, 7.7%; p<0.001). Conclusions This study suggests that among the COVID-19 suspected patients admitted in EDs and requiring a hospitalization, the management was different according to the confirmed COVID-19 status and required different resources in terms of ICU beds and ventilator support.