Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study
Abstract Background Long-COVID research to date focuses on outcomes in non-hospitalised vs. hospitalised survivors. However Emergency Department attendees (post-ED) presenting with acute COVID-19 may experience less supported recovery compared to people admitted and discharged from hospital (post-ho...
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BMC
2025-01-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-024-01164-x |
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| author | Anita Saigal Songyuan Xiao Owais Siddique Prasheena Naran Heba M Bintalib Camila Nagoda Niklewicz George Seligmann Sindhu Bhaarrati Naidu Amar J Shah Chibueze Ogbonnaya John R Hurst Marc Ci Lipman Swapna Mandal |
| author_facet | Anita Saigal Songyuan Xiao Owais Siddique Prasheena Naran Heba M Bintalib Camila Nagoda Niklewicz George Seligmann Sindhu Bhaarrati Naidu Amar J Shah Chibueze Ogbonnaya John R Hurst Marc Ci Lipman Swapna Mandal |
| author_sort | Anita Saigal |
| collection | DOAJ |
| description | Abstract Background Long-COVID research to date focuses on outcomes in non-hospitalised vs. hospitalised survivors. However Emergency Department attendees (post-ED) presenting with acute COVID-19 may experience less supported recovery compared to people admitted and discharged from hospital (post-hospitalised group, PH). Objective We evaluated outcomes and predictors of specialty care referrals (SCR) in those with ongoing symptomatic Long-COVID, comparing post-ED and PH adults. Methods This prospective observational cohort study evaluates 800 PH and 484 post-ED adults from a single hospital in London, United Kingdom. Participants had either confirmed laboratory-positive SARS-CoV-2 infection or clinically suspected acute COVID-19 and were offered post-COVID clinical follow-up at approximately six weeks after their ED attendance or inpatient discharge, to assess ongoing symptoms and support recovery. Multiple logistic regression determined associations with specialist care referrals (SCR) to respiratory, cardiology, physiotherapy (including chest physiotherapy), and mental health services. Results Presence of at least one Long-COVID symptom was lower in adults attending ED services with acute COVID-19 compared to those hospitalised (70.1% post-ED vs. 79.5% PH adults, p < 0.001). Total number of Long-COVID symptoms was associated with increased SCR in all patients (adjusted odds ratio (aOR) = 1.26, 95%CI:1.16, 1.36, p < 0.001), with post-ED adults more likely to need a SCR overall (aOR = 1.82, 95%CI:1.19, 2.79, p = 0.006). Post-ED adults had higher SCR to both physiotherapy (aOR = 2.59, 95%CI:1.35, 4.96, p = 0.004) and mental health services (aOR = 3.84, 95%CI:2.00, 7.37, p < 0.001), with pre-existing mental illness linked to the latter (aOR = 4.08, 95%CI:1.07, 15.6, p = 0.04). Conclusions We demonstrate greater specialist care referrals to mental health and physiotherapy services in patients attending the ED and discharged with acute COVID-19, compared to those admitted, despite lower ongoing COVID-19 symptom burden. Total number of symptoms, pre-existing co-morbidity such as smoking status, cardiac co-morbidities, and mental health illnesses may predict those requiring healthcare input. This information may enable better post-COVID support for ED attendees, a distinct group who should not be neglected when preparing for future pandemics. Trial registration This study had HRA approval (20/HRA/4928). |
| format | Article |
| id | doaj-art-04071c6ec137467597cd2205f981dac1 |
| institution | Kabale University |
| issn | 1471-227X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Emergency Medicine |
| spelling | doaj-art-04071c6ec137467597cd2205f981dac12025-01-26T12:18:29ZengBMCBMC Emergency Medicine1471-227X2025-01-0125111310.1186/s12873-024-01164-xPredictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort studyAnita Saigal0Songyuan Xiao1Owais Siddique2Prasheena Naran3Heba M Bintalib4Camila Nagoda Niklewicz5George Seligmann6Sindhu Bhaarrati Naidu7Amar J Shah8Chibueze Ogbonnaya9John R Hurst10Marc Ci Lipman11Swapna Mandal12UCL Respiratory, University College LondonUCL Respiratory, University College LondonUCL Respiratory, University College LondonRespiratory Medicine, Royal Free London NHS Foundation TrustUCL Respiratory, University College LondonRespiratory Medicine, Royal Free London NHS Foundation TrustRespiratory Medicine, Royal Free London NHS Foundation TrustUCL Respiratory, University College LondonUCL Respiratory, University College LondonInstitute of Child Health, University College LondonUCL Respiratory, University College LondonUCL Respiratory, University College LondonUCL Respiratory, University College LondonAbstract Background Long-COVID research to date focuses on outcomes in non-hospitalised vs. hospitalised survivors. However Emergency Department attendees (post-ED) presenting with acute COVID-19 may experience less supported recovery compared to people admitted and discharged from hospital (post-hospitalised group, PH). Objective We evaluated outcomes and predictors of specialty care referrals (SCR) in those with ongoing symptomatic Long-COVID, comparing post-ED and PH adults. Methods This prospective observational cohort study evaluates 800 PH and 484 post-ED adults from a single hospital in London, United Kingdom. Participants had either confirmed laboratory-positive SARS-CoV-2 infection or clinically suspected acute COVID-19 and were offered post-COVID clinical follow-up at approximately six weeks after their ED attendance or inpatient discharge, to assess ongoing symptoms and support recovery. Multiple logistic regression determined associations with specialist care referrals (SCR) to respiratory, cardiology, physiotherapy (including chest physiotherapy), and mental health services. Results Presence of at least one Long-COVID symptom was lower in adults attending ED services with acute COVID-19 compared to those hospitalised (70.1% post-ED vs. 79.5% PH adults, p < 0.001). Total number of Long-COVID symptoms was associated with increased SCR in all patients (adjusted odds ratio (aOR) = 1.26, 95%CI:1.16, 1.36, p < 0.001), with post-ED adults more likely to need a SCR overall (aOR = 1.82, 95%CI:1.19, 2.79, p = 0.006). Post-ED adults had higher SCR to both physiotherapy (aOR = 2.59, 95%CI:1.35, 4.96, p = 0.004) and mental health services (aOR = 3.84, 95%CI:2.00, 7.37, p < 0.001), with pre-existing mental illness linked to the latter (aOR = 4.08, 95%CI:1.07, 15.6, p = 0.04). Conclusions We demonstrate greater specialist care referrals to mental health and physiotherapy services in patients attending the ED and discharged with acute COVID-19, compared to those admitted, despite lower ongoing COVID-19 symptom burden. Total number of symptoms, pre-existing co-morbidity such as smoking status, cardiac co-morbidities, and mental health illnesses may predict those requiring healthcare input. This information may enable better post-COVID support for ED attendees, a distinct group who should not be neglected when preparing for future pandemics. Trial registration This study had HRA approval (20/HRA/4928).https://doi.org/10.1186/s12873-024-01164-xLong-COVIDOngoing symptomatic COVID-19Emergency departmentSARS-CoV-2 |
| spellingShingle | Anita Saigal Songyuan Xiao Owais Siddique Prasheena Naran Heba M Bintalib Camila Nagoda Niklewicz George Seligmann Sindhu Bhaarrati Naidu Amar J Shah Chibueze Ogbonnaya John R Hurst Marc Ci Lipman Swapna Mandal Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study BMC Emergency Medicine Long-COVID Ongoing symptomatic COVID-19 Emergency department SARS-CoV-2 |
| title | Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study |
| title_full | Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study |
| title_fullStr | Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study |
| title_full_unstemmed | Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study |
| title_short | Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study |
| title_sort | predictors of specialist care referrals scr following emergency department review or hospital admission in adults with previous acute covid 19 a prospective uk cohort study |
| topic | Long-COVID Ongoing symptomatic COVID-19 Emergency department SARS-CoV-2 |
| url | https://doi.org/10.1186/s12873-024-01164-x |
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