Non-hospitalized Adults with COVID-19 Differ Noticeably from Hospitalized Adults in Their Demographic, Clinical, and Social Characteristics.

• Type of Material: Article
• Authors: Sharon Bergquist, Emory University; Clyde Partin, Emory University; David Roberts, Emory University; James O'Keefe, Emory University; Elizabeth J. Tong, Emory University; Jennifer Zreloff, Emory University; Thomas L. Jarrett, Emory University; Miranda Moore, Emory University
• Language: English
• Date: 2020-08-14
• Publisher: Springer
• Publication Version: Final Published Version
• Copyright Statement: © Springer Nature Switzerland AG 2020
• Final Published Version (URL): http://dx.doi.org/10.1007/s42399-020-00453-3
• Title of Journal or Parent Work: SN Compr Clin Med
• Start Page: 1
• End Page: 9
• Keywords: Outpatient; Comorbidities; Non-hospitalized; SARS-CoV-2; COVID-19; Characteristics; Telemedicine
• Research Categories: Biology, Virology; Health Sciences, Health Care Management; Health Sciences, Public Health

Abstract

The characteristics of patients with coronavirus disease 2019 (COVID-19) have primarily been described in hospitalized adults. Characterization of COVID-19 in ambulatory care is needed for a better understanding of its evolving epidemiology. Our aim is to provide a description of the demographics, comorbidities, clinical presentation, and social factors in confirmed SARS-CoV-2-positive non-hospitalized adults. We conducted a retrospective medical record review of 208 confirmed SARS-CoV-2-positive patients treated in a COVID-19 virtual outpatient management clinic established in an academic health system in Georgia. The mean age was 47.8 (range 21-88) and 69.2% were female. By race/ethnicity, 49.5% were non-Hispanic African American, 25.5% other/unknown, 22.6% non-Hispanic white, and 2.4% Hispanic. Nearly 70% had at least one preexisting medical condition. The most common presenting symptoms were cough (75.5%), loss of smell or taste (63%), headache (62%), and body aches (54.3%). Physician or advanced practice provider assessed symptom severity ranged from 51.9% mild, 30.3% moderate, and 1.4% severe. Only eight reported limitations to home care (3.8%), 55.3% had a caregiver available, and 93.3% reported initiating self-isolation. Care needs were met for 83.2%. Our results suggest the demographic and clinical characteristics of COVID-19 illness in non-hospitalized adults differ considerably from hospitalized patients and warrant greater awareness of risk among younger and healthier individuals and consideration of testing and recommending self-isolation for a wider spectrum of clinical symptoms by clinicians. Social factors may also influence the efficacy of preventive strategies and allocation of resources toward the SARS-CoV-2 pandemic.