Retrospective analysis of asymptomatic COVID‐19 patients presenting to emergency department

Gormeli Kurt, Nazli; Gunes, Celal

OBJECTIVE: In this study, we aimed to investigate the clinical and demographic characteristics of asymptomatic COVID‐19 cases incidentally diagnosed at the emergency department. METHODOLOGY: This study retrospectively analysed the medical data of patients who presented to the emergency department, between March 1 and May 1, 2020, without COVID‐19 symptoms such as fever, cough, myalgia on admission but were incidentally detected to have thoracic computerised tomography (CT) findings suggestive of COVID‐19. The patients’ sociodemographic and epidemiological characteristics, laboratory test results, clinical and radiological findings, treatment protocols and prognoses were recorded. RESULTS: We incidentally diagnosed COVID‐19 pneumonia in 81 asymptomatic patients. All patients presented to the emergency department with traumatic injuries. Of these, 38 (46%) were injured in in‐vehicle traffic accidents; 27 (34%) out‐of‐vehicle traffic accidents; 14 (18%) simple falls; and 2 (2%) falls from a height. Only 42 (48%) patients had a history of suspected contact with a COVID‐19 positive individual. The mean time to symptom onset of 81 patients was 5 ± 2 days. An analysis based on thoracic computerised tomography findings showed that the common finding found in all patients was ground glass opacity (GGO). While 55 (68%) patients had GGO alone, 10 (12%) had additional fine reticulations; 6 (7%) had an additional halo sign; 6 (7%) had an additional air bronchogram and 4 (5%) had an additional area of consolidation. None of the patients died during follow‐up, and all of them were discharged. CONCLUSION: Early identification and isolation of asymptomatic patients are of great importance for reducing the speed of propagation of the COVID‐19 pandemic. Incidentally diagnosed cases have made us consider that there is a need to increase the number of screening tests. We also believe that healthcare staff should suspect COVID‐19 pneumonia in every patient irrespective of presentation type, place importance on the use of personal protective equipment (PPE), and not examine any patient without wearing PPE.