155: Can It Wait? Do Delays in Presentation Affect Outcomes in COVID-19 Patients?

INTRODUCTION: Since the outbreak of the COVID-19 pandemic, advising patients on when to seek care for their symptoms has been a challenge Patients may present to the hospital late in their disease course and only when symptom severity cannot be avoided any longer due to lack of access to healthcare or fear of hospitalization It is unclear if these delays in care affect clinical treatments or hospital outcomes We aimed to determine if the reported length of pre-admission symptoms in COVID-19 patients was associated with significant differences in critical care outcomes We hypothesized that patients who delayed care would experience worse outcomes METHODS: We utilized registry data on hospitalized COVID-positive patients from an urban, academic, medical center All patients with a finalized dataset were included Patients were stratified by length of symptoms (1-5 days, 6-10 days or more than 10 days) prior to admission We compared the rate of ICU admission, SOFA and APACHE scores on admission, intubation status, and mortality Chisquare tests and logistic regression models were used RESULTS: A total of 247 patients were included The mean age was 62 years and 47 87% were female Of these patients, 78 (33 5%) were admitted to the ICU There was no significant difference in ICU admission rate between groups (1-5 days: 26 9%;6-10 days: 35 3%;>10 days: 37 9%;p=0 30) There was no significant difference in SOFA or APACHE score categories by group (p=0 64 and p=0 90, respectively) Additionally, there were no significant differences in rate of intubation (p=0 12), or in-hospital mortality (p=0 33) After controlling for age, BMI, and gender, logistic regression analysis demonstrated no significant difference between groups for rate of ICU admission, rate of intubation, or in-hospital mortality CONCLUSIONS: We have demonstrated that the reported length of pre-admission symptoms in COVID-positive patients was not a significant predictor of outcomes We had hypothesized patients with longer duration of pre-admission symptoms would exhibit worse outcomes However, we posit the expeditious development and implementation of remote monitoring programs and outpatient management by our institution could have allowed for timely intervention in patients whose clinical status was deteriorating