Corpus overview


Overview

MeSH Disease

Fever (118)

Cough (66)

Coronavirus Infections (55)

Dyspnea (50)

Fatigue (41)


Human Phenotype

Cough (150)

Fever (132)

Pneumonia (47)

Fatigue (45)

Hypertension (40)


Transmission

Seroprevalence
    displaying 1 - 10 records in total 150
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    Clinical-epidemiological and treatment characteristics of children TRANS with COVID-19 in a tertiary referral center in Peru

    Authors: Christian Chiara-Chilet; Medalit Luna-Vilchez; Julio Maquera-Afaray; Blanca Salazar-Mesones; Diana Portillo-Alvarez; Ramiro Priale-Miranda; Franklin Mendoza-Torres; Aldo Munayco-Perez; Yeny Baca-Cama; Mitsi Santiago-Abad; Jose W Lopez; - Pediatric COVID-19 Working Group INSN SB; Alexandra Trkola; Jan Fehr; Milo A Puhan; Susi Kriemler; Peter Hau; Christopher Bohr; Ralph Burkhardt; Andre Gessner; Bernd Salzberger; Frank Hanses; Florian Hitzenbichler; Daniel Heudobler; Florian Lueke; Tobias Pukrop; Wolfgang Herr; Daniel Wolff; Hendrik Poeck; Christoph Brochhausen; Petra Hoffmann; Michael Rehli; Marina Kreutz; Kathrin Renner

    doi:10.1101/2020.09.18.20186866 Date: 2020-09-18 Source: medRxiv

    Introduction The COVID-19 pandemic has a great impact on children TRANS's health. This study describes the clinical, epidemiological and treatment characteristics of children TRANS presenting COVID-19 at the Instituto Nacional de Salud del Nino San Borja (INSN-SB) Methods This was a retrospective study of patients with a confirmed diagnosis of COVID-19 from March to July 2020. Demographic, clinical, laboratory, radiological, and treatment information were collected. Data analysis included descriptive statistics and bivariate analysis to determine differences between patients in general wards and the intensive care unit (ICU). Results We included 91 patients, 33 being females TRANS (36.3%). The most affected age group TRANS was children TRANS > 2 years of age TRANS (63 cases) with a median age TRANS of 6 years (IQR 3-10), and 61.5% were from Lima. The previous contact was determined in 30.8% of cases. A positive SARS CoV-2 PCR result was obtained in 50.6%. The presence of comorbidity was 53.8%. The most frequent symptoms were: fever HP (39.6%), general malaise (23.1%), cough HP (19.8%), and respiratory distress HP (14.3%). The presence of multisystem inflammatory syndrome MESHD in children TRANS (MIS-C) was confirmed in 6 patients. Antibiotics were administered in 76.9%. The most frequent radiological pattern was bilateral interstitial infiltrates (57.7%). Mortality was higher in patients in the ICU than in the hospitalization ward (27.3% vs. 4.3%, respectively; p = 0.02) Conclusions COVID-19 in children TRANS presents mild and moderate clinical manifestations. The presence of comorbidity is an important factor for hospitalization, and mortality is high upon admission to critical care units.

    Predicting clinical outcome with phenotypic clusters in COVID-19 pneumonia HP pneumonia MESHD: 2 an analysis of 12,066 hospitalized patients from the Spanish registry SEMI-3 COVID-19.

    Authors: Manuel Rubio-Rivas; Xavier Corbella; Jose Maria Mora-Lujan; Jose Loureiro Amigo; Almudena Lopez Sampalo; Carmen Yera Bergua; Pedro Jesus Esteve Atienzar; Luis Felipe Diez Garcia; Ruth Gonzalez Ferrer; Susana Plaza Canteli; Antia Perez Pineiro; Begona Cortes Rodriguez; Leyre Jorquer Vidal; Ignacio Perez Catalan; Marta Leon Tellez; Jose Angel Martin Oterino; Maria Candelaria Martin Gonzalez; Jose Luis Serrano Carrillo de Albornoz; Eva Garcia Sardon; Jose Nicolas Alcala Pedrajas; Anabel Martin Urda Diez Canseco; Maria Jose Esteban Giner; Pablo Telleria Gomez; Ricardo Gomez Huelgas; Jose Manuel Ramos Rincon; Nina la Cour Freiesleben; Henriette Svarre Nielsen

    doi:10.1101/2020.09.14.20193995 Date: 2020-09-15 Source: medRxiv

    (1) Background: This study aims to identify different clinical phenotypes in COVID-19 88 pneumonia HP pneumonia MESHD using cluster analysis and to assess the prognostic impact among identified clusters in 89 such patients. (2) Methods: Cluster analysis including 11 phenotypic variables was performed in a 90 large cohort of 12,066 COVID-19 patients, collected and followed-up from March 1, to July 31, 2020, 91 from the nationwide Spanish SEMI-COVID-19 Registry. (3) Results: Of the total of 12,066 patients 92 included in the study, most were males TRANS (7,052, 58.5%) and Caucasian (10,635, 89.5%), with a mean 93 age TRANS at diagnosis of 67 years (SD 16). The main pre-admission comorbidities were arterial 94 hypertension HP hypertension MESHD (6,030, 50%), hyperlipidemia HP hyperlipidemia MESHD (4,741, 39.4%) and diabetes mellitus HP diabetes mellitus MESHD (2,309, 19.2%). The 95 average number of days from COVID-19 symptom onset TRANS to hospital admission was 6.7 days (SD 7). 96 The triad of fever HP fever MESHD, cough HP cough MESHD, and dyspnea HP dyspnea MESHD was present almost uniformly in all 4 clinical phenotypes 97 identified by clustering. Cluster C1 (8,737 patients, 72.4%) was the largest, and comprised patients 98 with the triad alone. Cluster C2 (1,196 patients, 9.9%) also presented with ageusia and anosmia MESHD anosmia HP; 99 cluster C3 (880 patients, 7.3%) also had arthromyalgia, headache HP headache MESHD, and sore throat; and cluster C4 100 (1,253 patients, 10.4%) also manifested with diarrhea HP diarrhea MESHD, vomiting HP vomiting MESHD, and abdominal pain HP abdominal pain MESHD. Compared to 101 each other, cluster C1 presented the highest in-hospital mortality (24.1% vs. 4.3% vs. 14.7% vs. 102 18.6%; p<0.001). The multivariate study identified phenotypic clusters as an independent factor for 103 in-hospital death. (4) Conclusion: The present study identified 4 phenotypic clusters in patients with 104 COVID-19 pneumonia HP pneumonia MESHD, which predicted the in-hospital prognosis of clinical outcomes.

    Effect of Arbidol on COVID-19: A Randomized Controlled Trial

    Authors: Marzieh Nojomi; Zainab Yasin; Hossein Keyvani; Mahin Jamshidi Makiani; Maryam Roham; Azadeh Laali; Nasir Dehghan; Mehrnaz Navaei; Mitra Ranjbar

    doi:10.21203/rs.3.rs-78316/v1 Date: 2020-09-15 Source: ResearchSquare

    Background: The treatment of patients with COVID-19 included supportive care to relief the symptoms mainly. Although WHO mentioned there is not any effective treatments for COVID-19, but there is some reporting about the use of some antiviral drugs. The aim of current study is to determine the effect of Arbidol (ARB) on COVID-19 disease. Methods: Using an open label randomized controlled trial, effectiveness of ARB on COVID-19 disease was conducted in a teaching hospital. One hundred eligible patients with diagnosis of Covid-19 recruited in the study and assigned randomly to two groups of either Hydroxychloroquine followed by Kaletra (Lopinavir-ritonavir) or Hydroxychloroquine followed by ARB. The primary outcome was hospitalization duration and clinical improvement 7 days after admission. The criteria of improvement were relief of cough HP, dyspnea HP dyspnea MESHD and fever HP. Time to relieving fever HP fever MESHD was assessed across two groups too. Without any drop out, 100 patients were entered to final analysis with significant level of 0.05. Results: The mean age TRANS of the patients was 56.6 (17.8) and 56.2 (14.8) in ARB and Kaletra groups respectively. Majority of patients were male TRANS across two groups (66% and 54%). The duration of hospitalization in ARB group was less than Kaletra arm significantly (7.2 versus 9.6 days; P=0.02). Time to relief fever HP fever MESHD was almost similar across two groups (2.7 versus 3.1 days in ARB and Kaletra arms respectively). Peripheral oxygen saturation rate was different after seven days of admission across two groups significantly (94% versus 92% in ARB and Kaletra groups respectively) (P=0.02). Based on multiple linear regression analysis, IHD, Na level and oxygen saturation at the time of admission and type of therapy were the independent adjusted variables that determined the duration of hospitalization in patients with COVID-19.Conclusion: Our findings showed that Arbidol, compared to Kaletra, significantly contributes to clinical and laboratory improvements, including peripheral oxygen saturation, requiring ICU admissions, duration of hospitalization, chest CT involvements, WBC, and ESR. We suggest further studies on ARB using larger sample size and multicenter design.Trial registration: IRCT20180725040596N2 on 18 April 2020.

    Risk Factors Analysis of COVID-19 Patients with ARDS MESHD and Prediction Based on Machine Learning

    Authors: Wan Xu; Nan-Nan Sun; Hai-Nv Gao; Zhi-Yuan Chen; Ya Yang; Bin Ju; Ling-Ling Tang

    doi:10.21203/rs.3.rs-77820/v1 Date: 2020-09-15 Source: ResearchSquare

    COVID-19 is a newly emerging infectious disease MESHD, which is generally susceptible to human beings and has caused huge losses to people's health. Acute respiratory distress HP respiratory distress MESHD syndrome ( ARDS MESHD) is one of the common clinical manifestations of severe COVID-19 and it is also responsible for the current shortage of ventilators worldwide. This study aims to analyze the clinical characteristics of COVID-19 ARDS MESHD patients and establish a diagnostic system based on artificial intelligence (AI) method to predict the probability of ARDS in COVID-19 patients. We collected clinical data of 659 COVID-19 patients from 11 regions in China. The clinical characteristics of the two groups were elaborately compared and both traditional machine learning algorithms MESHD and deep learning-based methods were used to build the prediction models. Results indicated the median age TRANS of ARDS MESHD patients was 56.5 years old, which was significantly older than those with non-ARDS by 7.5 years. Male TRANS and patients with BMI>25 were more likely to develop ARDS MESHD. The clinical features of ARDS MESHD patients included cough HP (80.3%), polypnea (59.2%), lung consolidation (53.9%), secondary bacterial infection MESHD (30.3%), and comorbidities such as hypertension HP hypertension MESHD (48.7%). Abnormal biochemical indicators such as lymphocyte count, leukocyte counting, CK, NLR, AST, LDH, and CRP were all strongly related to the aggravation of ARDS. Furthermore, through various AI methods for modeling and prediction effect evaluation based on the above risk factors, decision tree achieved the best AUC, sensitivity SERO, and specificity in identifying the mild patients who were easy to develop ARDS MESHD, which undoubtedly helps to optimize the treatment strategy, reduce mortality, and relieve the medical pressure. 

    Alternative or Complementary Role of Serological Rapid Antibody Test SERO in the Management of Possible COVID-19 Cases

    Authors: Fatma Yildirim; Pinar Yildiz Gulhan; Ozlem Ercen Diken; Aylin Capraz; Meltem Simsek; Berna Botan Yildirim; Muhammet Ridvan Taysi; Sakine Yilmaz Ozturk; Nurcan Demirtas; Julide Ergil; Adem Dirican; Tugce Uzar; Irem Karaman; Sevket OZKAYA; Elisa Resconi; Monica I Lupei; Christopher J Tignanelli

    doi:10.1101/2020.09.13.20193615 Date: 2020-09-14 Source: medRxiv

    Background: Although the gold diagnostic method for COVID-19 is accepted as the detection of viral particles by reverse transcription polymerase chain reaction (RT-PCR), serology testing for SARS-CoV-2 is at increased demand. A primary aim for utilization of serological tests SERO are to better quantify the number of COVID-19 cases including those RT-PCR samples were negative but showing clinical and radiological signs of COVID-19. In this study, we aimed to report the features of the patients that were diagnosed and treated as possible COVID-19 cases whose multiple nasopharyngeal swab samples were negative by RT-PCR but serological IgM/IgG antibody SERO against SARS-CoV-2 were detected by rapid antibody test SERO. Method: We retrospectively analyzed eighty suspected COVID-19 cases that have at least two negative consecutive COVID-19 PCR test and were subjected to serological rapid antibody test SERO. Result: The specific antibodies SERO against SARS-CoV-2 were detected as positive in twenty-two patients. The mean age TRANS of patient group was 63.2+-13.1 years old with male TRANS / female TRANS ratio 11/11. Cough HP was the most common symptom with 90.9%. Most common presenting chest CT findings were bilateral ground glass opacities (77.2%) and alveolar MESHD consolidations (50.09%). The mean duration from symptom initiation to hospital admission, to hospitalization, to treatment initiation and to detection of antibody SERO positivity were 8.6 +- 7.2, 11.2 +- 5.4, 7.9 +- 3.2 and 24 +- 17 days, respectively. Conclusion: Our study demonstrated the feasibility of COVID-19 diagnosis based on rapid antibody test SERO in the cases of patients whose RT-PCR samples were negative. We suggest that the detection of antibodies SERO against SARS-CoV-2 with rapid antibody test SERO should be included in the diagnostic algorithm in suspected COVID-19 patients.

    The Effect of Early Hydroxychloroquine-based Therapy in COVID-19 Patients in Ambulatory Care Settings: A Nationwide Prospective Cohort Study

    Authors: Tarek Sulaiman; Abdulrhman Mohana; Laila Alawdah; Nagla Mahmoud; Mustafa Hassanein; Tariq Wani; Amel Alfaifi; Eissa Alenazi; Nashwa Radwan; Nasser AlKhalifah; Ehab Elkady; Manwer AlAnazi; Mohammed Alqahtani; Khalid Abdalla; Yousif Yousif; Fouad AboGazalah; Fuad Awwad; Khaled AlabdulKareem; Fahad AlGhofaili; Ahmed AlJedai; Hani Jokhdar; Fahad Alrabiah

    doi:10.1101/2020.09.09.20184143 Date: 2020-09-13 Source: medRxiv

    ABSTRACT BACKGROUND: Currently, there is no proven effective therapy nor vaccine for the treatment of SARS-CoV-2. Evidence regarding the potential benefit of early administration of hydroxychloroquine (HCQ) therapy in symptomatic patients with Coronavirus Disease MESHD (COVID-19) is not clear. METHODS: This observational prospective cohort study took place in 238 ambulatory fever HP clinics in Saudi Arabia, which followed the Ministry of Health (MOH) COVID-19 treatment guideline. This guideline included multiple treatment options for COVID-19 based on the best available evidence at the time, among which was Hydroxychloroquine (HCQ). Patients with confirmed COVD-19 (by reverse transcriptase polymerase chain reaction (PCR) test) who presented to these clinics with mild to moderate symptoms during the period from 5-26 June 2020 were included in this study. Our study looked at those who received HCQ-based therapy along with supportive care (SC) and compared them to patients who received SC alone. The primary outcome was hospital admission within 28-days of presentation. The secondary outcome was a composite of intensive care admission (ICU) and/or mortality during the follow-up period. Outcome data were assessed through a follow-up telephonic questionnaire at day 28 and were further verified with national hospitalisation and mortality registries. Multiple logistic regression model was used to control for prespecified confounders. RESULTS: Of the 7,892 symptomatic PCR-confirmed COVID-19 patients who visited the ambulatory fever HP clinics during the study period, 5,541 had verified clinical outcomes at day 28 (1,817 patients in the HCQ group vs 3,724 in the SC group). At baseline, patients who received HCQ therapy were more likely to be males TRANS who did not have hypertension HP hypertension MESHD or chronic lung disease HP lung disease MESHD compared to the SC group. No major differences were noted regarding other comorbid conditions. All patients were presenting with active complaints; however, the HCQ groups had higher rates of symptoms compared to the SC group ( fever HP fever MESHD: 84% vs 66.3, headache HP headache MESHD: 49.8 vs 37.4, cough HP: 44.5 vs 35.6, respectively). Early HCQ-based therapy was associated with a lower hospital admission within 28-days compared to SC alone (9.4% compared to 16.6%, RRR 43%, p-value <0.001). The composite outcome of ICU admission and/or mortality at 28-days was also lower in the HCQ group compared to the SC (1.2% compared to 2.6%, RRR 54%, p-value 0.001). Adjusting for age TRANS, gender TRANS, and major comorbid conditions, a multivariate logistic regression model showed a decrease in the odds of hospitalisation in patients who received HCQ compared to SC alone (adjusted OR 0.57 [95% CI 0.47-0.69], p-value <0.001). The composite outcome of ICU admission and/or mortality was also lower for the HCQ group compared to the SC group controlling for potential confounders (adjusted OR 0.55 [95% CI 0.34-0.91], p-value 0.019). CONCLUSION: Early intervention with HCQ-based therapy in patients with mild to moderate symptoms at presentation is associated with lower adverse clinical outcomes among COVID-19 patients, including hospital admissions, ICU admission, and/or death.

    Clinical Characteristics, Risk Factors and Predictive Value of COVID-19 Pneumonia HP: A Retrospective Study of 173 Patients in Wuhan, China

    Authors: Yang Zhang; Jun Xue; Mi Yan; Jing Chen; Hai Liu; Shao-Bo Wang; Jian-Xing Luo; Fang Yang; Jian-Yuan Tang; Xiao-Yu Hu

    doi:10.21203/rs.3.rs-76134/v1 Date: 2020-09-11 Source: ResearchSquare

    Background: COVID-19 is a globally emerging infectious disease MESHD. As the global epidemic continues to spread, the risk of COVID-19 transmission TRANS and diffusion in the world will also remain. Currently, several studies describing its clinical characteristics have focused on the initial outbreak, but rarely to the later stage. Here we described clinical characteristics, risk factors for disease severity and in-hospital outcome in patients with COVID-19 pneumonia HP pneumonia MESHD from Wuhan. Methods: Patients with COVID-19 pneumonia HP pneumonia MESHD admitted to Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 13 to March 8, 2020, were retrospectively enrolled. Multivariable logistic regression analysis was used to identify risk factors for disease severity and in-hospital outcome and establish predictive models. Receiver operating characteristic (ROC) curve was used to assess the predictive value of above models.Results: 106 (61.3%) of the patients were female TRANS. The mean age TRANS of study populations was 62.0 years, of whom 73 (42.2%) had underlying comorbidities mainly including hypertension HP hypertension MESHD (24.9%). The most common symptoms on admission were fever HP fever MESHD (67.6%) and cough HP (60.1%), digestive symptoms (22.0%) was also very common. Older age TRANS (OR: 3.420; 95%Cl: 1.415-8.266; P=0.006), diarrhea HP diarrhea MESHD (OR: 0.143; 95%Cl: 0.033-0.611; P=0.009) and lymphopenia HP lymphopenia MESHD (OR: 4.769; 95%Cl: 2.019-11.266; P=0.000) were associated with severe illness on admission; the area under the ROC curve (AUC) of predictive model were 0.860 (95%CI: 0.802-0.918; P=0.000). Older age TRANS (OR: 0.309; 95%Cl: 0.142-0.674; P=0.003), leucopenia (OR: 0.165; 95%Cl: 0.034-0.793; P=0.025), increased lactic dehydrogenase (OR: 0.257; 95%Cl: 0.100-0.659; P=0.005) and interleukins-6 levels (OR: 0.294; 95%Cl: 0.099-0.872; P=0.027) were associated with poor in-hospital outcome; AUC of predictive model were 0.752 (95%CI: 0.681-0.824; P=0.000).Conclusion: Older patients with diarrhea HP diarrhea MESHD and lymphopenia HP lymphopenia MESHD need early identification and timely intervention to prevent the progression to severe COVID-19 pneumonia HP pneumonia MESHD. However, older patients with leucopenia, increased lactic dehydrogenase and interleukins-6 levels are at a high risk for poor in-hospital outcome.Trial registration: ChiCTR2000029549

    Epidemiology and clinical outcome of COVID-19: A multi-centre cross sectional study from Bangladesh

    Authors: Adnan Mannan; H.M. Hamidullah Mehedi; Naim Hasan Chy; Md. Omar Qayum; Farhana Akter; Abdur Rob; Prasun Biswas; Sanjida Hossain; Mustak Ibn Ayub; Nardin Rezk; Annarita Giliberti; Alessandra Renieri; Yiheng Chen; Sirui Zhou; Vincenzo Forgetta; J Brent Richards

    doi:10.1101/2020.09.09.20191114 Date: 2020-09-10 Source: medRxiv

    Objectives: To investigate SARS-CoV-2 associated epidemiology and clinical outcomes in Bangladesh to understand the course of COVID-19 pandemic and suggest prevention measures. Methods: A cross-sectional retrospective study was conducted among 1,021 RT-PCR confirmed but recovered COVID-19 cases from six participating hospitals in Bangladesh. Results: Of the total sample, 111 (10.9%) cases were asymptomatic TRANS while the number of symptomatic cases were 910 (89.1%). Higher prevalence SERO of COVID-19 persisted in the male TRANS population (75%) and for the 31-40 age group TRANS. More than 85% of the samples reported BCG vaccination mark. Common symptoms observed in our study samples were fever HP fever MESHD (72.4%), cough HP (55.9%), loss of taste MESHD (40.7%) and body ache MESHD (40%); whereas for the biochemical parameters, Neutrophil (46.4%), D-dimer (46.1%), Ferritin (37.9%) and SGPT (36.8%) levels were found elevated. Post-COVID complications including pain HP pain MESHD (31.8%), loss of concentration (24.4%) and anxiety HP anxiety MESHD or depression (23.1%) were found significantly prevalent. Conclusion: Our study has shown that adult TRANS males TRANS aged TRANS between 31-40 in Bangladesh are more vulnerable to being infected with COVID-19. With an indication for the rising trend of the asymptomatic TRANS cases, deployment of interventions to curb further community spread is necessary to avoid the grave outcomes of COVID-19 in Bangladesh.

    Outcome of COVID-19 with Co-Existing Surgical Emergencies in Children TRANS: Our Initial Experiences and Recommendations

    Authors: Samiul Hasan; Md Ayub Ali; Umama Huq

    doi:10.21203/rs.3.rs-71589/v1 Date: 2020-09-03 Source: ResearchSquare

    Background: COVID-19 has changed the practice of surgery vividly all over the world. This has already lead to a huge burden of rescheduled pediatric surgical cases worldwide. Though children TRANS are less likely to be infected MESHD and suffer less when infected, there is a growing fear among health care workers of being self-infected, which is limiting the surgical care of children TRANS globally. This study aims to share our experiences with the outcome of COVID-19 in children TRANS who had a co-existing surgical emergency, which might help the pediatric surgeons globally to mitigate the effect of COVID 19 on pediatric surgery.Methods: This is a retrospective observational study. We reviewed the epidemiological, clinical, and laboratory data of all patients admitted in our surgery department through the emergency department and later diagnosed to have COVID-19 by RT-PCR. During April 2020 – June 2020. A nasopharyngeal swab was taken from all patients irrespective of symptoms to detect SARS CoV 2 by RT-PCR to identify and isolate asymptomatic TRANS patients and patients with atypical symptoms. We divided the test positive patients into 4 age groups TRANS for the convenience of data analysis. Data were retrieved from hospital records and analyzed using SPSS (version 25) software. Ethical permission was taken from the hospital ethical review board.Results: Total patients were 32. Seven (21.9%) of them were neonates. Twenty-four (75%) patients were male TRANS. The predominant diagnosis was acute abdomen followed by infantile hypertrophic pyloric stenosis MESHD pyloric stenosis HP (IHPS), myelomeningocele HP, and intussusception HP. Only two patients had mild respiratory symptoms MESHD ( dry cough MESHD cough HP). Fever HP Fever MESHD was present in 13 (40.6%) patients. Fourteen (43.8%) patients required surgical treatment. The mean duration of hospital stay was 5.5 days. One neonate with ARM died in the post-operative ward due to cardiac arrest HP cardiac arrest MESHD. No patient had hypoxemia HP hypoxemia MESHD or organ failure. Seven health care workers (5.51%) including doctors & nurses got infected with SARS Co V2 during this period.Conclusion: Our study has revealed a milder course of COVID-19 in children TRANS with minimal infectivity even when present in association with emergency surgical conditions. This might encourage a gradual restart to mitigate the impact of COVID-19 on children’s surgery.

    The clinical course of COVID-19 in the outpatient setting: a prospective cohort study

    Authors: Paul W Blair; Diane M Brown; Minyoung Jang; Annukka AR Antar; Jeanne C Keruly; Vismaya Bachu; Jenny L Townsend; Jeffrey A Tornheim; Sara C Keller; Lauren Sauer; David L Thomas; Yukari C Manabe; - Ambulatory COVID Study Team; Graham Medley; Michael Hohle; John Edmunds; Chris Fitzsimmons; Tim Harris; Fiona Lecky; Andrew Lee; Ian Maconochie; Darren Walter; Dilek Telci; Fikrettin Sahin; Koray Yalcin; Ercument Ovali

    doi:10.1101/2020.09.01.20184937 Date: 2020-09-03 Source: medRxiv

    Background: Outpatient COVID-19 has been insufficiently characterized. Objective: To determine the progression of disease and subsequent determinants of hospitalization. Design: A prospective outpatient cohort. Setting: Outpatients were recruited by phone between April 21 to June 23, 2020 after receiving outpatient or emergency department testing within a large health network in Maryland, USA. Participants: Outpatient adults TRANS with positive RT-PCR results for SARS-CoV-2. Measurements: Symptoms, portable pulse oximeter oxygen saturation (SaO2), heart rate, and temperature were collected by participants on days 0, 3, 7, 14, 21, and 28 after enrollment. Baseline demographics, comorbid conditions were evaluated for risk of subsequent hospitalization using negative binomial, logistic, and random effects logistic regression. Results: Among 118 SARS-CoV-2 infected MESHD outpatients, the median age TRANS was 56.0 years (IQR, 50.0 to 63.0) and 50 (42.4%) were male TRANS. Among those reporting active symptoms, the most common symptoms during the first week since symptom onset TRANS included weakness/fatigue MESHD fatigue HP (67.3%), cough HP (58.0%), headache HP headache MESHD (43.8%), and sore throat (34.8%). Participants returned to their usual health a median of 20 days (IQR, 13 to 38) from the symptom onset TRANS, and only 65.5% of respondents were at their usual health during the fourth week of illness. Over 28 days, 10.9% presented to the emergency department and 7.6% required hospitalization. Individuals at the same duration of illness had a 6.1 times increased adjusted odds of subsequent hospitalization per every percent decrease in home SaO2 (95% confidence interval [CI]: 1.41 to 31.23, p=0.02). Limitations: Severity and duration of illness may differ in a younger population. Conclusion: Symptoms often persisted but uncommonly progressed to hospitalization. Home SaO2 might be an important adjunctive tool to identify progression of COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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