Saigal, Anita;
Xiao, Songyuan;
Siddique, Owais;
Naran, Prasheena;
Bintalib, Heba M;
Niklewicz, Camila Nagoda;
Seligmann, George;
... Mandal, Swapna; + view all
(2025)
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
, 25
(1)
, Article 11. 10.1186/s12873-024-01164-x.
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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).
Type: | Article |
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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 |
Location: | England |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1186/s12873-024-01164-x |
Publisher version: | https://doi.org/10.1186/s12873-024-01164-x |
Language: | English |
Additional information: | Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
Keywords: | Science & Technology, Life Sciences & Biomedicine, Emergency Medicine, Long-COVID, Ongoing symptomatic COVID-19, Emergency department, SARS-CoV-2, TRAUMA SCREENING QUESTIONNAIRE, VALIDITY |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Respiratory Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
URI: | https://discovery.ucl.ac.uk/id/eprint/10206423 |




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