Prevalence of COVID-19 Among Typical Ambulatory Care Patients in a District General Hospital in the United Kingdom

Objectives This observational retrospective study was undertaken to ascertain the prevalence of coronavirus disease 2019 (COVID-19) among typical ambulatory care patients. In our hospital, ambulatory care unit (ACU) was supposed to be a COVID-19 free area, and, hence, as per the guidelines, even basic personal protection equipment (PPE) was not provided during the early phase of pandemic. Methods We identified 443 patients who presented to our ACU between March and June 2020 with chest pain or shortness of breath suspected of pulmonary embolism or acute coronary syndrome, which normally makes the bulk of referrals to ACU. As per protocol, patients with COVID-19-like symptoms, e.g., fever, cough, sore throat, and loss of taste and smell, were excluded from ACU. We then, reviewed computed tomography (CT) scans for radiological evidence of COVID-19, and lab data for COVID-19 polymerase chain reaction (PCR) or antibody tests, to find out if any of our patients turned out to be suffering from COVID-19 unexpectedly. Results We found 13 patients with radiological or serological evidence of COVID-19, which equates to a prevalence of 2.93% in this cohort of our ambulatory care patients. Four in our patient cohort showed radiological features that were highly suggestive of COVID-19 pneumonia; 47 chest CT scans were performed, which may suggest a prevalence of around 8.5% (4/47) on radiological ground if everyone was offered a CT scan. Conclusions Due to limited access to data, our result is likely an underestimation of the actual prevalence of COVID-19 among our ACU patients, highlighting the need to review the safety and PPE guidelines for the ambulatory clinic and any similar out-patient areas.