Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset
Introduction: Most initial COVID-19 research focused on hospitalized patients. Presenting symptomatology in the outpatient setting was poorly characterized, making it difficult for primary care physicians to predict which patients would require hospitalization. The purpose of this study was to chara...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | AJPM Focus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773065422000049 |
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| author | Gretchen L. Mockler, MD Samantha P. Novotny, BS Wei Hou, PhD Yuhang Liu, MS Elinor R. Schoenfeld, PhD |
| author_facet | Gretchen L. Mockler, MD Samantha P. Novotny, BS Wei Hou, PhD Yuhang Liu, MS Elinor R. Schoenfeld, PhD |
| author_sort | Gretchen L. Mockler, MD |
| collection | DOAJ |
| description | Introduction: Most initial COVID-19 research focused on hospitalized patients. Presenting symptomatology in the outpatient setting was poorly characterized, making it difficult for primary care physicians to predict which patients would require hospitalization. The purpose of this study was to characterize the presenting symptoms of COVID-19 infection and baseline patient characteristics and evaluate for correlation with disease severity, duration, and chronicity in the outpatient setting. Methods: A total of 107 adult, English-speaking patients with suspected and confirmed COVID-19 cases at the 3 primary care practices of Stony Brook University Hospital were studied between March and December 2020. Survey data were collected from patient telephone interviews and electronic medical record abstraction. The potential risk factors assessed included participant demographics, medical comorbidities, and the number and type of symptoms at illness onset. Outcome measures included symptom duration, hospitalizations, and persistence of symptoms at 12 weeks from study enrollment. Results: Patient self-report survey elicited nearly twice as many symptoms described at illness onset as those recorded in the electronic medical record (p<0.0001). A higher number of symptoms at illness onset was positively associated with symptom duration and chronicity. The presence of fever and hypoxia at the onset of illness were each positively associated with eventual hospitalization for COVID-19 disease. Conclusions: Early in the setting of newly emerging infectious diseases, particularly those such as COVID-19 that involve multiple organ systems, patient self-report of symptoms using a complete review of systems rather than electronic medical record abstraction alone may be key for accurate disease identification and characterization as well as prediction of eventual disease severity, duration, and chronicity. |
| first_indexed | 2024-04-11T08:17:34Z |
| format | Article |
| id | doaj.art-f82a8579c4fa47f7afd02f29ce57c6b6 |
| institution | Directory Open Access Journal |
| issn | 2773-0654 |
| language | English |
| last_indexed | 2024-04-11T08:17:34Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJPM Focus |
| spelling | doaj.art-f82a8579c4fa47f7afd02f29ce57c6b62022-12-22T04:35:04ZengElsevierAJPM Focus2773-06542022-09-0111100005Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness OnsetGretchen L. Mockler, MD0Samantha P. Novotny, BS1Wei Hou, PhD2Yuhang Liu, MS3Elinor R. Schoenfeld, PhD4Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University Hospital, Stony Brook, New York; Address correspondence to: Gretchen L. Mockler, MD, Department of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University Hospital, HSC L3, Room 086, Stony Brook NY 11794-8036.Renaissance School of Medicine, Stony Brook University Hospital, Stony Brook, New YorkDepartment of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University Hospital, Stony Brook, New YorkDepartment of Applied Mathematics & Statistics, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, New YorkDepartment of Family, Population & Preventive Medicine, Renaissance School of Medicine, Stony Brook University Hospital, Stony Brook, New YorkIntroduction: Most initial COVID-19 research focused on hospitalized patients. Presenting symptomatology in the outpatient setting was poorly characterized, making it difficult for primary care physicians to predict which patients would require hospitalization. The purpose of this study was to characterize the presenting symptoms of COVID-19 infection and baseline patient characteristics and evaluate for correlation with disease severity, duration, and chronicity in the outpatient setting. Methods: A total of 107 adult, English-speaking patients with suspected and confirmed COVID-19 cases at the 3 primary care practices of Stony Brook University Hospital were studied between March and December 2020. Survey data were collected from patient telephone interviews and electronic medical record abstraction. The potential risk factors assessed included participant demographics, medical comorbidities, and the number and type of symptoms at illness onset. Outcome measures included symptom duration, hospitalizations, and persistence of symptoms at 12 weeks from study enrollment. Results: Patient self-report survey elicited nearly twice as many symptoms described at illness onset as those recorded in the electronic medical record (p<0.0001). A higher number of symptoms at illness onset was positively associated with symptom duration and chronicity. The presence of fever and hypoxia at the onset of illness were each positively associated with eventual hospitalization for COVID-19 disease. Conclusions: Early in the setting of newly emerging infectious diseases, particularly those such as COVID-19 that involve multiple organ systems, patient self-report of symptoms using a complete review of systems rather than electronic medical record abstraction alone may be key for accurate disease identification and characterization as well as prediction of eventual disease severity, duration, and chronicity.http://www.sciencedirect.com/science/article/pii/S2773065422000049COVID-19SARS-CoV-2hospitalization |
| spellingShingle | Gretchen L. Mockler, MD Samantha P. Novotny, BS Wei Hou, PhD Yuhang Liu, MS Elinor R. Schoenfeld, PhD Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset AJPM Focus COVID-19 SARS-CoV-2 hospitalization |
| title | Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset |
| title_full | Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset |
| title_fullStr | Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset |
| title_full_unstemmed | Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset |
| title_short | Patient Self-Report Superior to Electronic Medical Record Abstraction for Identifying Positive COVID-19 Symptoms at Illness Onset |
| title_sort | patient self report superior to electronic medical record abstraction for identifying positive covid 19 symptoms at illness onset |
| topic | COVID-19 SARS-CoV-2 hospitalization |
| url | http://www.sciencedirect.com/science/article/pii/S2773065422000049 |
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