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. 2021 Jul 19;29(1):95.
doi: 10.1186/s13049-021-00915-0.

Prehospital characteristics of COVID-19 patients in Helsinki - experience of the first wave of the pandemic

Markku Kuisma  1 , Heini Harve-Rytsälä  2 , Jussi Pirneskoski  2 , James Boyd  2 , Mitja Lääperi  2 , Ari Salo  2 , Tuukka Puolakka  2   3
Affiliations

Prehospital characteristics of COVID-19 patients in Helsinki - experience of the first wave of the pandemic

Markku Kuisma et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: There is a lack of knowledge how patients with COVID-19 disease differ from patients with similar signs or symptoms (but who will have a diagnosis other than COVID-19) in the prehospital setting. The aim of this study was to compare the characteristics of these two patient groups met by the emergency medical services.

Methods: All prehospital patients after the World Health Organisation (WHO) pandemic declaration 11.3.2020 until 30.6.2020 were recruited for the study. The patients were screened using modified WHO criteria for suspected COVID-19. Data from the electronic prehospital patient reporting system were linked with hospital laboratory results to check the laboratory confirmation for COVID-19. For comparison, we divided the patients into two groups: screening- and laboratory-positive patients with a hospital diagnosis of COVID-19 and screening-positive but laboratory-negative patients who eventually received a different diagnosis in hospital.

Results: A total of 4157 prehospital patients fulfilled the criteria for suspected COVID-19 infection during the study period. Five-hundred-thirty-six (12.9%) of the suspected cases received a laboratory confirmation for COVID-19. The proportion of positive cases in relation to suspected ones peaked during the first 2 weeks after the declaration of the pandemic. In the comparison of laboratory-positive and laboratory-negative cases, there were clinically insignificant differences between the groups in age, tympanic temperature, systolic blood pressure, heart rate, on-scene time, urgency category of the call and mode of transportation. Foreign-language-speakers were overrepresented amongst the positive cases over native language speakers (26,6% vs. 7,4%, p < 0,001). The number of cases in which no signs or symptoms of COVID-19 disease were reported, but patients turned out to have a positive test result was 125 (0,3% of the whole EMS patient population and 11,9% of all verified COVID-19 patients encountered by the EMS).

Conclusions: In a sample of suspected COVID-19 patients, the laboratory-positive and laboratory-negative patients were clinically indistinguishable from each other during the prehospital assessment. Foreign-language-speakers had a high likelihood of having Covid-19. The modified WHO criteria still form the basis of screening of suspected COVID-19 patients in the prehospital setting.

Keywords: Ambulance; COVID-19; Emergency medical services; Prehospital; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Description of study sample. EMS = emergency medical services
Fig. 2
Fig. 2
Timeline of suspected cases of COVID-19 with a final diagnosis other than COVID-19 compared against laboratory confirmed COVID-19 cases
See this image and copyright information in PMC

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