Clinical Characteristics and Factors Associated with Same-encounter Hospital Admission Among Symptomatic Adults Presenting to the Emergency Department After COVID-19
Eurasian Journal of Emergency Medicine, sa.25, ss.467-473, 2026 (ESCI, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: Sayı: 25
- Basım Tarihi: 2026
- Doi Numarası: 10.4274/eajem.galenos.2026.45403
- Dergi Adı: Eurasian Journal of Emergency Medicine
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.467-473
- İnönü Üniversitesi Adresli: Evet
Özet
Aim: To evaluate adults with previously documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who presented to the emergency department with new or persistent symptoms at least 4 weeks after acute coronavirus disease 2019 (COVID-19). Materials and Methods: We examined presenting symptoms; demographic and clinical characteristics, laboratory and imaging findings; and factors concurrently associated with all-cause hospital admission during the index post-acute emergency department encounter. Medical records of 760 patients with documented previous SARS-CoV-2 infection who presented to the emergency department between January 2020 and November 2022 were reviewed. Patients with ongoing polymerase chain reaction positivity (n=54), with complaints clearly unrelated to the post-acute presentation (n=74), with incomplete laboratory data (n=84), or aged <18 years (n=48) were excluded. The final cohort comprised 500 patients who presented at least 4 weeks after the documented acute COVID-19 diagnosis. Results: Of the 500 patients, 275 (55.0%) were female and 225 (45.0%) were male; the median age was 52 years (range, 18-90). Thirty patients had an all-cause hospital admission during the index post-acute emergency department encounter. Admission was more frequent among patients who had required hospital-based care during acute COVID-19 than among those managed as outpatients (19.3% vs. 2.3%; p<0.001). After Holm adjustment, white blood cell count, neutrophil count, blood urea nitrogen, C-reactive protein, procalcitonin (PCT), N-terminal pro-B-type natriuretic peptide, and D-dimer levels were significantly higher among hospitalized patients. In the post hoc exploratory Firth-penalized multivariable model, older age, higher PCT and D-dimer levels, and acute-period hospitalization were associated with same-encounter admission after adjustment. Conclusion: Older age, higher concurrent PCT and D-dimer levels, and hospitalization during acute COVID-19 were associated with all-cause admission at the index post-acute emergency department encounter. These exploratory same-encounter associations do not establish prediction, causation, or hospitalization attributable to a post-COVID condition, and they require external validation.