Confirmation of COVID-19 in Out-of-Hospital Cardiac Arrest Patients and Postmortem Management in the Emergency Department during the COVID-19 Outbreak

Kim Changho; Yeo In Hwan; Kim Jong Kun; Cho Yeonjoo; Lee Mi Jin; Jung Haewon; Cho Jae Wan; Ham Ji Yeon; Lee Suk Hee; Chung Han Sol; Mun You Ho; Lee Sang Hun; Kim Yang Hun

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자료유형: 학술저널

저자정보: Kim Changho (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Yeo In Hwan (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Kim Jong Kun (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Cho Yeonjoo (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Lee Mi Jin (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Jung Haewon (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Cho Jae Wan (Department of Emergency Medicine School of Medicine Kyungpook National University Daegu Korea.) Ham Ji Yeon (Department of Clinical Pathology School of Medicine Kyungpook National University Daegu Korea.) Lee Suk Hee (Department of Emergency Medicine Daegu Catholic University Daegu Korea.) Chung Han Sol (Department of Emergency Medicine College of Medicine Yeungnam University Daegu Korea.) Mun You Ho (Department of Emergency Medicine College of Medicine Yeungnam University Daegu Korea.) Lee Sang Hun (Department of Emergency Medicine Keimyung University Dongsan Hospital Daegu Korea.) Kim Yang Hun (Department of Emergency Medicine Daegu Fatima Hospital Daegu Korea.)

저널정보: 대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제52권 제4호

발행연도: 2020.1

수록면: 562 - 572 (11page)

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Background: There is currently a lack of evidence-based postresuscitation or postmortem guidelines for patients with out-of-hospital cardiac arrest (OHCA) in the setting of an emerging infectious disease. This study aimed to develop and validate a multimodal screening tool that aids in predicting the disease confirmation in emergency situations and patients with OHCA during a coronavirus disease 2019 (COVID-19) outbreak. Materials and Methods: We conducted a retrospective, multicenter observational study of adult patients with OHCA in Daegu, Korea. To identify the potential predictors that could be used in screening tools in the emergency department, we applied logistic regression to data collected from March 1 to March 14. The prediction performance of the screening variables was then assessed and validated on the data of patients with OHCA who were treated between February 19 and March 31, 2020. General patient characteristics and hematological findings of the COVID-19-negative and COVID-19-positive groups were compared. We also evaluated confirmation test criteria as predictors for COVID-19 positivity in patients with OHCA. Results: Advanced age, body temperature, and abnormal chest X-ray (CXR) revealed significant predictive ability in the derivation cohort. Of the 184 adult patients with OHCA identified in the validation cohort, 80 patients were included in the analysis. Notably, 9 patients were positive and 71 were negative on the COVID-19 reverse transcription polymerase chain reaction test. Five patients (55.6%) in the COVID-19-positive group had a fever before OHCA, and 12 (16.9%) of the COVID-19-negative group had a fever before OHCA (P = 0.018). Eight patients (88.9%) in the COVID-19-positive group had a CXR indicating pneumonic infiltration. Of the criteria for predicting COVID-19, fever or an abnormal CXR had a sensitivity of 100% (95% confidence interval [CI]: 65.4 ? 100) and a specificity of 22.5% (95% CI: 13.5 ? 34.0). Conclusion: The screening tools that combined fever or abnormal CXR had a good discriminatory ability for COVID-19 infection in adult patients with OHCA. Therefore, during the COVID-19 outbreak period, it is recommended to suspect COVID-19 infection and perform COVID-19 test if patients present with a history of fever or show abnormal findings in postmortem CXR.

#COVID-19 #Heart arrest #Fever #Chest X-ray #Screening

참고문헌 (10)

참고문헌 신청

Korea Centers for Disease Control and Prevention (KCDC) / Press release

Korean Society of Infectious Diseases / 2020 / Analysis on 54 Mortality Cases of Coronavirus Disease 2019 in the Republic of Korea from January 19 to March 10, 2020 / Journal of Korean Medical Science 35(12):1~9

Korean Society of Infectious Diseases / 2020 / Report on the Epidemiological Features of Coronavirus Disease 2019 (COVID-19) Outbreak in the Republic of Korea from January 19 to March 2, 2020 / Journal of Korean Medical Science 35(10):1~11

Korean Statistical Information Service (KOSIS) / Population by administrative region

Han Sol Chung / 2020 / Revised Triage and Surveillance Protocols for Temporary Emergency Department Closures in Tertiary Hospitals as a Response to COVID-19 Crisis in Daegu Metropolitan City / Journal of Korean Medical Science 35(19):1~10

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