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RAPID score in Covid-19 patients: a clinical-radiological index for the safe discharge from the Emergency Department. A preliminary report

Authors

Filippo Vaccher
f.vaccher@unibs.it
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia; Radiologia 2, ASST Spedali Civili di Brescia, Italy.
Ciro Paolillo
Emergency Department, ASST Spedali Civili di Brescia, Brescia, Italy.
Nunzia Di Meo
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia; Radiologia 2, ASST Spedali Civili di Brescia, Italy.
Marco Ramanzin
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia; Radiologia 2, ASST Spedali Civili di Brescia, Italy.
Marco Ravanelli
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia; Radiologia 2, ASST Spedali Civili di Brescia, Italy.
Roberto Maroldi
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia; Radiologia 2, ASST Spedali Civili di Brescia, Italy.
Davide Farina
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia; Radiologia 2, ASST Spedali Civili di Brescia, Italy.

To evaluate the performance of a clinical-radiological index (RAPID-Covid score) in achieving Safe Discharge (SD) of patients accessing the Emergency Department (ED) with symptoms suggesting Covid-19. Clinical and radiological data were retrospectively collected from 853 consecutive patients admitted to the ED during the pandemics with symptoms suggesting Covid-19. Illness severity was graded with RAPID-Covid score, composed of chest X-ray findings, clinical symptoms and PaO2/FiO2. Patients with RAPIDCovid score ≥5 were admitted. Primary outcome was SD of patients to home care. SD was defined as survival of the patient, without evidence of second access to ED requiring hospitalization. 212/853 patients were discharged. 27/212 had a score ≥5 but refused admission. 185/212 were discharged with score <5: 147/185 (79,5%) survived and did not re-access ED; 1/185 (0,5%) died at home after first ED-dismissal; 37/185 (20,0%) had a second access. Of these 15/37 (8,1%) were newly dismissed and one of them (1/15) died at home; 22/37 (11,9%) were hospitalized, 1/22 died during hospitalization. SD was obtained in 161/185 patients (87%). Readmissions occurred 5,1±2,6days from first discharge. Follow-up was 16,7±6,0days. RAPID-Covid score proves useful for SD of Covid-19 to home care. 6-10days may further increase confidence.

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How to Cite

Vaccher, F., Paolillo, C., Di Meo, N., Ramanzin, M., Ravanelli, M., Maroldi, R., & Farina, D. (2020). RAPID score in Covid-19 patients: a clinical-radiological index for the safe discharge from the Emergency Department. A preliminary report. Emergency Care Journal, 16(3). https://doi.org/10.4081/ecj.2020.9192

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