At-risk COVID-19 Patients; Knowledge and Attitude of Those in Need of Transfer to Hospital and Consequences in Non-transferred Patients

Background: Knowledge, attitude, and practice of people, especially high-risk ones, are essential for managing COVID-19. Previous studies have shown that inappropriate knowledge and attitude may influence people's decisions. Objectives: This study aimed to evaluate the knowledge and attitudes of patients towards COVID-19 who called emergency medical service (EMS) while suffering from a chronic underlying disease, whether they were transferred to the hospital during the pandemic or not. Methods: This cross-sectional study was conducted from 21 May 2020 to 20 June 2020 in Tehran, Iran. Using the registered data in the databank of the Tehran EMS center, eligible participants were selected and divided into transferred and non-transferred groups based on the recorded data. A valid and reliable questionnaire comprising four parts (demographic information, patients' knowledge about COVID-19, patients' attitude towards COVID-19, and patients' fear) was used. A researcher-made checklist was also used for recording the consequences and reasons for refusal. Select eligible individuals who agreed to enter the survey were interviewed by telephone. Results: Totally, 201 transferred patients and 158 non-transferred patients were enrolled. The mean age of the transferred group was lower than that of the non-transferred one (57.1 ± 16.1 vs. 62.0 ± 17.4 years; P = 0.006). The mean knowledge score was not statistically different between transferred and non-transferred patients (28.8 ± 5.7 vs. 28.2 ± 5.4; P = 0.320). The mean attitude score was lower in the transferred group than in the non-transferred group (0.75 ± 3.7 vs. 2.2 ± 3.5; P = 0.001). The mean fear score was higher in the non-transferred group than in the transferred group, but the difference was not statistically significant (16.0 ± 5.1 vs. 15.0 ± 5.6; P = 0.101). Conclusions: Most participants in both transferred and non-transferred groups did not have sufficient knowledge of the disease, but the average attitude had a positive score.