Prehospital identification of Covid-19: an observational study.
The novel coronavirus disease 2019 (Covid-19) pandemic has affected prehospital care systems across the world, but the prehospital presentation of affected patients and the extent to which prehospital care providers are able to identify them is not well characterized. In this study, we describe the presentation of Covid-19 patients in a Swedish prehospital care system, and asses the predictive value of Covid-19 suspicion as documented by dispatch and ambulance nurses.Data for all patients with dispatch, ambulance, and hospital records between January 1-August 31, 2020 were extracted. A descriptive statistical analysis of patients with and without hospital-confirmed Covid-19 was performed. In a subset of records beginning from April 14, we assessed the sensitivity and specificity of documented Covid-19 suspicion in dispatch and ambulance patient care records.A total of 11,894 prehospital records were included, of which 481 had a primary hospital diagnosis code related to-, or positive test results for Covid-19. Covid-19-positive patients had considerably worse outcomes than patients with negative test results, with 30-day mortality rates of 24% vs 11%, but lower levels of prehospital acuity (e.g. emergent transport rates of 14% vs 22%). About half (46%) of Covid-19-positive patients presented to dispatchers with primary complaints typically associated with Covid-19. Six thousand seven hundred seventy-six records were included in the assessment of predictive value. Sensitivity was 76% (95% CI 71-80) and 82% (78-86) for dispatch and ambulance suspicion respectively, while specificities were 86% (85-87) and 78% (77-79).While prehospital suspicion was strongly indicative of hospital-confirmed Covid-19, based on the sensitivity identified in this study, prehospital suspicion should not be relied upon as a single factor to rule out the need for isolation precautions. The data provided may be used to develop improved guidelines for identifying Covid-19 patients in the prehospital setting.
This is an abstract of the clinical research article “Prehospital identification of Covid-19: an observational study.” This clinical research article was published in the medical journal Scandinavian journal of trauma, resuscitation and emergency medicine on 2021-01-07 and has been categorised as belonging to the clinical specialty of Coronavirus. To read the full clinical research article or obtain a PDF (if available) use the links directly above. To discover more of the latest Coronavirus clinical research articles from the medical journal Scandinavian journal of trauma, resuscitation and emergency medicine please click the link below. For more of the latest Coronavirus research articles from other leading medical journals click the link that says Coronavirus next to the stethoscope icon at the top of the page. You can further filter clinical research articles by sub-specialties within Coronavirus using the navigation menu at the top of the page.