key: cord-0905500-2ndan331
authors: Shaw, Katharina S.; Karagounis, Theodora K.; Yin, Lu; Gibbon, Grace; Betensky, Rebecca A.; Lo Sicco, Kristen I.; Femia, Alisa N.
title: Response to “Patient preference for cellulitis treatment: at-home care is preferred to hospital-based treatment”
date: 2020-08-07
journal: J Am Acad Dermatol
DOI: 10.1016/j.jaad.2020.07.120
sha: 4b9b06bae7fed6360219a1c88a0bbfcb58a3f144
doc_id: 905500
cord_uid: 2ndan331

nan

preference of patients for at-home treatment of cellulitis rather than hospital-based care. 35

Notably, these results reflected patient preferences well before the onset of the COVID-19 36 pandemic. In light of recent reports linking patient anxiety over COVID-19 to delayed and 37 decreased hospital presentations for acute medical problems such as myocardial infarction 2 and 38 stroke 3 , we examined whether a similar trend was observed for patients presenting with skin and 39 soft tissue infections (SSTIs) at an urban tertiary care center in the epicenter of the COVID-19 40

After obtaining IRB approval, we queried emergency department (ED) visits at NYU Langone 42 2020 and 2019, respectively) . 62

Our findings highlight a similar pattern observed by our cardiology 2 and neurology 3 colleagues -63 namely, that fewer patients sought hospital-based care for acute dermatologic problems like 64

SSTIs during the height of the COVID-19 pandemic. These results suggest that some patients 65 with SSTIs may have avoided hospital-based evaluation and treatment due to fear of COVID-19. 66

While we can neither comment on whether these patients sought evaluation elsewhere (such as in 67 an outpatient or telemedicine setting) nor on the outcomes of patients who may have foregone 68 hospital evaluation for SSTIs, the findings of Gabel et al 1 have proven prescient. Thus, we argue 69 for careful risk stratification of patients diagnosed with cellulitis in outpatient, urgent care and 70 ED settings going forward. In the context of growing outbreaks in other states and concern for 71 heightened incidence of COVID-19 in the fall, we encourage outpatient treatment of cellulitis -72 including parenteral antimicrobial therapy when feasible -for those patients without relevant 73 risk factors for poor outcomes. Moreover, given that patients may be reluctant to seek hospital-74 based care, we highlight the need to remain accessible to patients in the outpatient setting or 75 through virtual visits, particularly during periods of stress on local hospital systems. 

Patient preference 79 for cellulitis treatment: at-home care is preferred to hospital-based treatment

ST-segment elevation cardiac catheterization laboratory activations in the United States during 83 COVID-19 pandemic

Eerie Emptiness of ERs Worries Doctors: Where are the Heart Attacks and 85