CORRESPONDENCE • CID 2021:72 (15 June) • e1159
especially at its onset [9]. However, the
application of a standard approach to
management of patients with acute res-
piratory failure and/or fever and the
knowledge of clinical and laboratory
characteristics of COVID-19 can drive
early therapeutic choices [10].
Notes
Author contributions. Conceived and designed
study: A. R. and V. B. Performed data collection:
A. R., V. B., L. B., F. M. C., G. C., R. P., A. S., and
R. R. Analyzed data: A. R. and V. B. Wrote the man-
uscript: A. R., G. C., G. D., F. P., C. M., and F. S.
Potential conficts of interest. Te authors: No
potential conficts of interest. All authors have
submitted the ICMJE Form for Disclosure of
Potential Conficts of Interest.
Alessandro Russo,
1
Valeria Bellelli,
1
Giancarlo Ceccarelli,
2
Federica Marincola Cattaneo,
1
Luigi Bianchi,
1
Roberto Pierro,
1
Roberta Russo,
1
Alessia Steffanina,
1
Francesco Pugliese,
3
Claudio Maria Mastroianni,
2
Gabriella d’Ettorre,
2
and
Francesco Sabetta
1
1
Internal Medicine Unit, Policlinico Casilino, Rome, Italy,
2
Department of Public Health and Infectious Diseases,
Sapienza University of Rome, Rome, Italy, and
3
Department of
Anesthesia and Intensive Care Medicine, Sapienza University
of Rome, Rome, Italy
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Correspondence: A. Russo, Internal Medicine Unit,
Policlinico Casilino, Via Casilina, 1049, Rome 00169, Italy
(alessandro.russo1982@gmail.com).
Clinical Infectious Diseases
®
2021;72(12):e1158–9
© The Author(s) 2020. Published by Oxford University Press for
the Infectious Diseases Society of America. All rights reserved.
For permissions, e-mail: journals.permissions@oup.com.
DOI: 10.1093/cid/ciaa1745
Reply to Russo et al
To the Editor—We thank Russo and col-
leagues for taking the time to critically
appraise and respond to our recent ar-
ticle. We assessed clinical and laboratory
characteristics of patients admitted to
the Sechenov University hospital net-
work in Moscow, Russia, for suspected
coronavirus disease 2019 (COVID-19)
infection. We read about the findings of
the RESILIENCY study [1] with great
interest, as they are much in agreement
with the results from our cohort. This
further confirms the importance of ap-
propriate clinical management of all ad-
mitted patients with suspected severe
acute respiratory syndrome coronavirus
2 (SARS-CoV-2) infection, irrespective
of the reverse-transcription polymerase
chain reaction (RT-PCR) result.
In their study, Russo et al [1] dem-
onstrated that more than half of the ad-
mitted patients did not have positive
Acute respiratory failure
and/or fever in Emergency
Department
1° nasopharingeal
swab
2° nasopharingeal
swab after 24 hours
Evaluation for
broncoalveolar
lavage for SARS-
CoV-2 detection
Follow-up with
lung ultrasound,
evaluation for
transthoracic
echocardiography
Negative
Negative
Blood cultures if
fever
PCT value >0.5
ng/ml: empiric
antibiotic
therapy
Including:
-Routine tests
-PCT
-CRP
-Antibodies for
SARS-CoV-2
-LDH
-CPK
-D-Dimer
-Hemogasanalysis
-Lactates
If excluded
SARS-CoV-2
etiology transfer
to non-COVID-19
section
Airborne
isolation
CT scan Blood exams
Figure 1. Management of suspected coronavirus disease 2019 at time of admission to emergency department. Abbreviations: COVID-19, coronavirus disease 2019; CPK,
creatine phosphokinase; CRP, C-reactive protein; CT, computed tomography; LDH, lactate dehydrogenase; NP, nasopharyngeal; PCT, procalcitonin; SARS-CoV-2, severe acute
respiratory syndrome coronavirus 2.
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