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COVID-19 patient experiences in prehospital pathways:a processual approach using life-events calendar method and state sequence analysis shows detrimental delays

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Family Medicine and Community Health 2024年第1期12卷 45-56页

作者： Romain Lutaud Sebastien Cortaredona Lea Delorme Patrick Peretti-watel Juliette Mirouse Manon Borg Lucie Cattaneo Didier Thery Gaetan Gentile Christian Pradier Touitou Irit Philippe Brouqui sophie tardieu Michel Carles Stéphanie Gentile Department of General Practice Aix-Marseille UniversityMarseilleFrance ADES MarseilleFrance Institut de Recherche pour le Développement(IRD) MarseilleFrance Assistance Publique-Hôpitaux de Marseille(AP-HM) MarseilleFrance INSERM MarseilleFrance Department of Public Health Archet University HospitalNiceFrance MEPHI MarseilleFrance CEReSS-Health Service Research and Quality of life Center MarseilleFrance Department of Infectious Diseases Centre Hospitalier Universitaire de NiceNiceFrance

Objectives To our best knowledge,no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19.‘Patients’voice is an excellent means to capture data on primary care *** aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences,and to test whether these clusters were associated with a higher risk of poor clinical *** Cross-sectional online survey using life-event *** All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in *** 312 patients responded to the *** outcome measures From the day of symptom onset to the day of hospitalisation,we defined a symptom sequence as the time-ordered vector of the successive symptom grades(grade 1,grade 2,grade 3).State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom *** logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit(ICU)and COVID-19 sequelae after *** Three clusters of symptom sequences were identified among 312 complete prehospital pathways.A specific group of patients(29%)experienced extended symptoms of severe COVID-19,persisting for an average duration of 7.5 days before *** group had a significantly higher probability of being admitted to ICU(adjusted OR 2.01).They were less likely to know a loved one who was a healthcare worker,and more likely to have a lower level of ***,this group of patients,who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time,may have been inclined to postpone reassessment when their health *** relatives played a decisive role in their *** and relevance This study h

关键词： admitted likely life

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