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COVID-19 emergency department discharges: an outcome study

David Lanham, Jennifer Roe, Alisha Chauhan, Rebecca Evans, Toby Hillman, Sarah Logan and Melissa Heightman
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DOI: https://doi.org/10.7861/clinmed.2020-0817
Clin Med January 2021
David Lanham
AUniversity College London Hospitals NHS Foundation Trust, London, UK
Roles: geriatric/acute medicine registrar
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  • For correspondence: david.lanham@nhs.net
Jennifer Roe
BUniversity College London Hospitals NHS Foundation Trust, London, UK
Roles: microbiology consultant
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Alisha Chauhan
CUniversity College London Hospitals NHS Foundation Trust, London, UK
Roles: foundation year doctor
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Rebecca Evans
CUniversity College London Hospitals NHS Foundation Trust, London, UK
Roles: foundation year doctor
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Toby Hillman
DUniversity College London Hospitals NHS Foundation Trust, London, UK
Roles: respiratory medicine consultant
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Sarah Logan
EUniversity College London Hospitals NHS Foundation Trust, London, UK.
Roles: infectious diseases consultant
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Melissa Heightman
DUniversity College London Hospitals NHS Foundation Trust, London, UK
Roles: respiratory medicine consultant
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ABSTRACT

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.

KEYWORDS
  • COVID-19
  • ED discharge policy
  • safety-net
  • outcomes
  • © Royal College of Physicians 2021. All rights reserved.
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COVID-19 emergency department discharges: an outcome study
David Lanham, Jennifer Roe, Alisha Chauhan, Rebecca Evans, Toby Hillman, Sarah Logan, Melissa Heightman
Clinical Medicine Jan 2021, clinmed.2020-0817; DOI: 10.7861/clinmed.2020-0817

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COVID-19 emergency department discharges: an outcome study
David Lanham, Jennifer Roe, Alisha Chauhan, Rebecca Evans, Toby Hillman, Sarah Logan, Melissa Heightman
Clinical Medicine Jan 2021, clinmed.2020-0817; DOI: 10.7861/clinmed.2020-0817
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