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

Sixty-eight individuals, including 2 children, were tested over 26 days. The majority were ambulant and able to self-isolate, and had features consistent with an upper respiratory tract viral infection, or common cold. After the first 10 cases, 6/58 (10.3%) were admitted, at least three of whom only because they lived in shared accommodation where self-isolation was unrealistic, rather than on clinical grounds. This observation supports a community testing approach for the majority. Five of fifty individuals were prescribed antimicrobials without being admitted, emphasising the importance of the availability of clinical decision makers and prescribers for more unwell patients. None of our cases had severe respiratory illness requiring non-invasive or mechanical ventilation, suggesting it will be rare that patients meeting the definition of a suspected case will require enhanced care, at least while COVID-19 itself remains rare in the UK. Some COVID-19 case series have suggested up to 20% of cases may require respiratory support 2,12 , although this figure may be influenced by ascertainment bias. If more generalised outbreaks occur outside China, we may start to see severe COVID-19 presenting to UK healthcare services.