Abstract
Introduction: After COVID-19 vaccination was initiated, the number of patients visiting the emergency department (ED) with vaccine-related adverse reactions increased. We investigated the clinical features of older adults (aged 65 years and older) visiting the ED with self-reported COVID-19 postvaccination fever.
Methods: We conducted a retrospective observational study at three EDs between March 2021 and September 2021. Patients who reported adverse reactions, fever (≥37.5 °C) and/or febrile sensation or rigors following COVID-19 vaccination were included. The demographic and clinical data of these patients were collected by reviewing their medical records.
Results: A total of 562 patients were selected, and 396 (70.5%) were female. The older adult group included 155 (27.6%) patients, and the median age was 75 (69-79 years). The older adults less frequently had a fever (≥37.5 °C) upon ED presentation (75.5% vs. 85.7%, respectively), used more emergency medical services (43.9% vs. 18.7%, respectively), and visited an ED more frequently during early hours (00:00-06:00) (31% vs. 20.1%, respectively) compared to the younger adults (p = 0.004, p < 0.001 and p = 0.036). Fewer older adults visited an ED within 2 days of fever onset (73.5% vs. 84%) (p = 0.012), and more older adults were admitted for medical conditions other than vaccine-related adverse reactions (32.9% vs. 4.2%) (p < 0.001). Older adults received more thorough testing (laboratory and imaging tests). Among the older adults, the admission rate was associated with age (p = 0.003).
Conclusion: Older adults presenting with fever as an adverse reaction following COVID-19 vaccination less frequently had a fever upon visiting the ED, required more ED testing, and had higher admission rates for non-vaccination-related medical conditions.
Keywords: Adverse reactions; COVID-19 vaccine; Emergency department; Fever; Older adults.
【저자키워드】 COVID-19 vaccine, Older adults, emergency department, Adverse reactions, Fever, 【초록키워드】 COVID-19, Laboratory, Adults, COVID-19 vaccination, female, Patient, age, Admission, patients, clinical feature, retrospective, Emergency, Adverse reaction, older adult, Medical conditions, medical records, medical service, Older, Adverse, Clinical data, febrile, rigor, postvaccination, Imaging tests, selected, collected, reported, investigated, required, conducted, less, initiated, presenting, medical condition, the median, 【제목키워드】 Older, Retrospective multicenter study,