68 Consecutive patients assessed for COVID-19 infection; experience from a UK regional infectious disease unit

Nicholas Easom; Peter Moss; Gavin Barlow; Anda Samson; Tom Taynton; Kate Adams; Monica Ivan; Phillipa Burns; Kavitha Gajee; Kirstine Eastick; Patrick Lillie

The copyright holder for this preprint . https://doi.org/10.1101/2020.02.29.20029462 doi: medRxiv preprint and after receiving a test result as these individuals will not readily be able to access the usual healthcare services. This may apply particularly to patients with pre-existing lung disease, where respiratory viral illness, caused by SARS-CoV-2 or otherwise, may trigger clinical deterioration that could ordinarily be managed by early community intervention. Infectious Diseases physicians may be the group best placed to support patients in this situation for the short period of self-isolation, 13 especially given the need for ongoing personal protective equipment use 14 . Although we did not observe any imported "tropical" infections such as dengue, malaria, typhoid, rickettsiosis or leptospirosis, these remain important differential diagnoses in returning travellers from some areas of South East Asia and may be life-threatening if missed 8, 15 . These diagnoses may become more common in this group now that the definition of a suspected case has been expanded to include other countries in South or South East Asia such as Vietnam. Individuals receiving testing for COVID-19 should be signposted to an accessible clinical service with an understanding of this differential diagnosis in case of worsening illness.