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

• Autor(a) principal: Accorsi,Tarso Augusto Duenhas
• Data de Publicação: 2020
• Outros Autores: Amicis,Karine De, Brígido,Alexandra Régia Dantas, Belfort,Deborah de Sá Pereira, Habrum,Fábio Cetinic, Scarpanti,Fernando Garcia, Magalhães,Iuri Resedá, Silva Filho,José Roberto de Oliveira, Sampaio,Leon Pablo Cartaxo, Lira,Maria Tereza Sampaio de Sousa, Morbeck,Renata Albaladejo, Pedrotti,Carlos Henrique Sartorato, Cordioli,Eduardo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Einstein (São Paulo)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082020000100287
• topic: Telemedicine; Coronavirus infections; COVID-19; Respiratory tract infections; Pandemics; Referral and consultation

ABSTRACT 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.