Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: the HOME-CoV rule

Delphine Douillet, Rafaël Mahieu, Violette Boiveau, Yves Marie Vandamme, Aurore Armand, Francois Morin, Dominique Savary, Vincent Dubée, Cédric Annweiler, Pierre Marie Roy, H. Andrianjafy, C. Annweiler, Aurore Armand, L. Baudin, L. Bekhir, F. Benezit, K. Benhammouda, P. Bissolokele, S. Blanchi, Violette BoiveauK. Bouiller, J. B. Bouillon, C. Brice, A. S. Brunel, C. Cayeux, B. Cazenave, A. Chauvin, Y. E. Claessens, H. Cormier, F. Coustilleres, N. Crochette, D. Dall Acqua, Delphine Douillet, F. Dupriez, E. Friou, C. Gangloff, S. Gennai, L. M. Joly, H. H. Karam, A. Le Bot, A. Lemaignen, A. Leroy, Rafaël Mahieu, N. Marchant, N. Marjanovic, E. Montassier, F. Morin, J. Pasquier, S. Patrat-Delon, A. Penaloza, G. Plantefeve, P. M. Roy, D. Sanderink, Dominique Savary, J. Schmidt, T. Schotte, C. Soulie, S. Tchangai-Kao, P. C. Thiebaud, E. Timsit, E. Trabattoni, J. M. Turmel, Yves Marie Vandamme, M. Violeau, J. C. Yombi

Risultato della ricerca: Articlepeer review

1 Citazioni (Scopus)

Abstract

In the context of the COVID-19 pandemic and overloaded hospitals, a central issue is the need to define reliable and consensual criteria for hospitalization or outpatient management in mild cases of COVID-19. Our aim was to define an easy-to-use clinical rule aiming to help emergency physicians in hospitalization or outpatient management decision-making for patients with suspected or confirmed SARS-CoV-2 infection (the HOME-CoV rule). The Delphi method was used to reach a consensus of a large panel of 51 experts: emergency physicians, geriatricians, infectious disease specialists, and ethical consultants. A preliminary list of eligible criteria was compiled based on a literature review. Four rounds of anonymized expert consultations were performed. The experts were asked to score each item as relevant, possibly relevant and non-relevant, as major or minor, and to choose the cut-off. They were also able make suggestions and remarks. Eight criteria constituting the HOME-CoV were selected: six correspond to the severity of clinical signs, one to the clinical course (clinically significant worsening within the last 24 h), and the last corresponds to the association of a severe comorbidity and an inadequate living context. Hospitalization is deemed necessary if a patient meets one or more of the criteria. In the end, 94.4% of the experts agreed with the defined rule. Thanks to the Delphi method, an absolute consensus was obtained of a large panel of experts on the HOME-CoV rule, a decision-making support mechanism for clinicians to target patients with suspected or confirmed COVID-19 requiring hospitalization. Trial registration: NCT04338841.
Lingua originaleEnglish
RivistaInternal and Emergency Medicine
Volume15
Numero di pubblicazione8
DOI
Stato di pubblicazionePublished - 1 nov 2020

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