@Article{duepublico_mods_00077574,
  author = 	{Fistera, David
		and H{\"a}rtl, Annalena
		and Pabst, Dirk
		and Manegold, Randi
		and Holzner, Carola
		and Taube, Christian
		and Dolff, Sebastian
		and Schaarschmidt, Benedikt Michael
		and Umutlu, Lale
		and Kill, Clemens
		and Risse, Joachim},
  title = 	{What about the others: differential diagnosis of COVID-19 in a German emergency department},
  year = 	{2021},
  month = 	{Sep},
  day = 	{17},
  keywords = 	{COVID-19; Differential diagnosis; Respiratory infection; Triage; Clinical symptoms; Emergency department; SARS-CoV-2},
  abstract = 	{Background: The ongoing COVID-19 pandemic remains a major challenge for worldwide health care systems and in particular emergency medicine. An early and safe triage in the emergency department (ED) is especially crucial for proper therapy. Clinical symptoms of COVID-19 comprise those of many common diseases; thus, differential diagnosis remains challenging. Method: We performed a retrospective study of 314 ED patients presenting with conceivable COVID-19 symptoms during the first wave in Germany. All were tested for COVID-19 with SARS-Cov-2-nasopharyngeal swabs. Forty-seven patients were positive. We analyzed the 267 COVID-19 negative patients for their main diagnosis and compared COVID-19 patients with COVID-19 negative respiratory infections for differences in laboratory parameters, symptoms, and vital signs. Results: Among the 267 COVID-19 negative patients, 42.7{\%} had respiratory, 14.2{\%} had other infectious, and 11.2{\%} had cardiovascular diseases. Further, 9.0{\%} and 6.7{\%} had oncological and gastroenterological diagnoses, respectively. Compared to COVID-19 negative airway infections, COVID-19 patients showed less dyspnea (OR 0.440; p = 0.024) but more dysgeusia (OR 7.631; p = 0.005). Their hospital stay was significantly longer (9.0 vs 5.6 days; p = 0.014), and their mortality significantly higher (OR 3.979; p = 0.014). Conclusion: For many common ED diagnoses, COVID-19 should be considered a differential diagnosis. COVID-19 cannot be distinguished from COVID-19 negative respiratory infections by clinical signs, symptoms, or laboratory results. When hospitalization is necessary, the clinical course of COVID-19 airway infections seems to be more severe compared to other respiratory infections.},
  note = 	{<p>The publication of this article was supported by the Publication Fund of the University of Duisburg-Essen.</p>

<p>Open Access funding enabled and organized by Projekt DEAL.</p>},
  note = 	{<p>Fistera, D., H{\"a}rtl, A., Pabst, D. <em>et al.</em> What about the others: differential diagnosis of COVID-19 in a German emergency department. <em>BMC Infect Dis</em> <strong> 21</strong>, 969 (2021). <a>https://doi.org/10.1186/s12879-021-06663-x</a></p>

<p>Published 17 September 2021</p>},
  note = 	{Version of Record / Verlagsversion},
  doi = 	{10.1186/s12879-021-06663-x},
  url = 	{https://duepublico2.uni-due.de/receive/duepublico_mods_00077574},
  url = 	{https://doi.org/10.1186/s12879-021-06663-x},
  file = 	{:https://duepublico2.uni-due.de/servlets/MCRFileNodeServlet/duepublico_derivate_00077225/BMC_Infect_Dis_2021_21_969.pdf:PDF},
  language = 	{en}
}