Evidence map›Paper›PMID 39849379›Full record

Observational studyBMC emergency medicine2025

Predictors of specialist care referrals (SCR) following emergency department review or hospital admission in adults with previous acute COVID-19: a prospective UK cohort study.

Anita Saigal, Songyuan Xiao, Owais Siddique, Prasheena Naran, Heba M Bintalib, Camila Nagoda Niklewicz, George Seligmann, Sindhu Bhaarrati Naidu, Amar J Shah, Chibueze Ogbonnaya and 3 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Anita Saigal *UCL Respiratory, University College London, London, UK. anita.saigal.20@ucl.ac.uk.
Songyuan Xiao *UCL Respiratory, University College London, London, UK.
Owais SiddiqueUCL Respiratory, University College London, London, UK.
Prasheena NaranRespiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.
Heba M BintalibUCL Respiratory, University College London, London, UK.
Camila Nagoda NiklewiczRespiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.
George SeligmannRespiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.
Sindhu Bhaarrati NaiduUCL Respiratory, University College London, London, UK.
Amar J ShahUCL Respiratory, University College London, London, UK.
Chibueze OgbonnayaInstitute of Child Health, University College London, London, UK.
John R HurstUCL Respiratory, University College London, London, UK.
Marc Ci LipmanUCL Respiratory, University College London, London, UK.
Swapna MandalUCL Respiratory, University College London, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-COVID research to date focuses on outcomes in non-hospitalised vs. hospitalised survivors. However Emergency Department attendees (post-ED) presenting with acute COVID-19 may experience less supported recovery compared to people admitted and discharged from hospital (post-hospitalised group, PH).

objectiveWe evaluated outcomes and predictors of specialty care referrals (SCR) in those with ongoing symptomatic Long-COVID, comparing post-ED and PH adults.

methodsThis prospective observational cohort study evaluates 800 PH and 484 post-ED adults from a single hospital in London, United Kingdom. Participants had either confirmed laboratory-positive SARS-CoV-2 infection or clinically suspected acute COVID-19 and were offered post-COVID clinical follow-up at approximately six weeks after their ED attendance or inpatient discharge, to assess ongoing symptoms and support recovery. Multiple logistic regression determined associations with specialist care referrals (SCR) to respiratory, cardiology, physiotherapy (including chest physiotherapy), and mental health services.

resultsPresence of at least one Long-COVID symptom was lower in adults attending ED services with acute COVID-19 compared to those hospitalised (70.1% post-ED vs. 79.5% PH adults, p < 0.001). Total number of Long-COVID symptoms was associated with increased SCR in all patients (adjusted odds ratio (aOR) = 1.26, 95%CI:1.16, 1.36, p < 0.001), with post-ED adults more likely to need a SCR overall (aOR = 1.82, 95%CI:1.19, 2.79, p = 0.006). Post-ED adults had higher SCR to both physiotherapy (aOR = 2.59, 95%CI:1.35, 4.96, p = 0.004) and mental health services (aOR = 3.84, 95%CI:2.00, 7.37, p < 0.001), with pre-existing mental illness linked to the latter (aOR = 4.08, 95%CI:1.07, 15.6, p = 0.04).

conclusionsWe demonstrate greater specialist care referrals to mental health and physiotherapy services in patients attending the ED and discharged with acute COVID-19, compared to those admitted, despite lower ongoing COVID-19 symptom burden. Total number of symptoms, pre-existing co-morbidity such as smoking status, cardiac co-morbidities, and mental health illnesses may predict those requiring healthcare input. This information may enable better post-COVID support for ED attendees, a distinct group who should not be neglected when preparing for future pandemics.

trial registrationThis study had HRA approval (20/HRA/4928).

Indexed as

COVID-19Emergency Service, HospitalHospitalizationReferral and ConsultationAdultAgedFemaleHumansLondonMaleMiddle AgedProspective StudiesSARS-CoV-2United KingdomEmergency departmentLong-COVIDOngoing symptomatic COVID-19SARS-CoV-2

Identifiers

PMID39849379
PMCPMC11756147

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.