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Observational Study
. 2021 Jan-Dec:12:21501327211017016.
doi: 10.1177/21501327211017016.

Characteristics and Outcomes of COVID-19 Infection from an Urban Ambulatory COVID-19 Clinic-Guidance for Outpatient Clinicians in Triaging Patients

Dweep Barbhaya  1 , Stephanie Franco  2 , Kejal Gandhi  1 , Radhika Arya  1 , Rabin Neupane  1 , Negar Foroughi  1 , Nnenna Oluigbo  1 , Dawn Fishbein  1   3 , Jennifer Tran  1
Affiliations
Observational Study

Characteristics and Outcomes of COVID-19 Infection from an Urban Ambulatory COVID-19 Clinic-Guidance for Outpatient Clinicians in Triaging Patients

Dweep Barbhaya et al. J Prim Care Community Health. 2021 Jan-Dec.

Abstract

Background: Coronavirus infection (COVID) presents with flu-like symptoms and can cause serious complications. Here, we discuss the presentation and outcomes of COVID in an ambulatory setting along with distribution of positive cases amongst healthcare workers (HCWs).

Method: Patients who visited the COVID clinic between 03/11/2020 and 06/14/2020 were tested based on the CDC guidelines at the time using PCR-detection methods. Medical records were reviewed and captured on a RedCap database. Statistical analysis was performed using both univariate and bivariate analysis using Fischer's exact test with 2-sided P values.

Results: Of the 2471 evaluated patients, 846 (34.2%) tested positive for COVID. Mean age of positivity was 43.4 years (SD ± 15.4), 60.1% were female and 49% were Black. 58.7% of people tested had a known exposure, and amongst those with exposure, 57.3% tested positive. Ninety-four patients were hospitalized (11.1%), of which 22 patients (23.4%) required ICU admission and 10 patients died. The overall death rate of patients presenting to clinic was 0.4%, or 1.2% amongst positive patients. Median length of hospital stay was 6 days (range 1-51). Symptoms significantly associated with COVID included: anosmia, fever, change in taste, anorexia, myalgias, cough, chills, and fatigue. Increased risk of COVID occurred with diabetes, whereas individuals with lung disease or malignancy were not associated with increased risk of COVID. Amongst COVID positive HCWs, the majority were registered nurses (23.4%), most working in general medicine (39.8%) followed by critical care units (14.3%).

Discussion/conclusion: Blacks and females had the highest infection rates. There was a broad range in presentation from those who are very ill and require hospitalization and those who remain ambulatory. The above data could assist health care professionals perform a targeted review of systems and co-morbidities, allowing for appropriate patient triage.

Keywords: COVID-19; ambulatory clinic; healthcare associated infection; high risk population; presenting symptoms.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Dawn Fishbein has served on a Gilead Advisory Board regarding HCV. However, No external funding for this COVID research was received.

Figures

Figure 1.
Figure 1.
Distribution of healthcare workers who tested positive based on their department of work (in %).
Figure 2.
Figure 2.
Distribution of healthcare workers who presented to the clinic (blue) and those who tested positive (red) based on their occupation.
Figure 3.
Figure 3.
Association (in odds ratios) of presenting symptoms and co-morbidities in COVID-19 positive patients when compared to COVID-19 negative patients.
See this image and copyright information in PMC

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