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Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients.

ABSTRACT: IMPORTANCE:The rapid pandemic expansion of the disease caused by the new SARS-CoV-2 virus has compromised health systems worldwide. Knowledge of prognostic factors in affected patients can help optimize care. OBJECTIVE:The objective of this study was to analyze the relationship between the prognosis of COVID-19 and the form of presentation of the disease, the previous pathologies of patients and their chronic treatments. DESIGN, PARTICIPANTS AND LOCATIONS:This was an observational study on a cohort of 418 patients admitted to three regional hospitals in Catalonia (Spain). As primary outcomes, severe disease (need for oxygen therapy via nonrebreather mask or mechanical ventilation) and death were studied. Multivariate binary logistic regression models were performed to study the association between the different factors and the results. RESULTS:Advanced age, male sex and obesity were independent markers of poor prognosis. The most frequent presenting symptom was fever, while dyspnea was associated with severe disease and the presence of cough with greater survival. Low oxygen saturation in the emergency room, elevated CRP in the emergency room and initial radiological involvement were all related to worse prognosis. The presence of eosinophilia (% of eosinophils) was an independent marker of less severe disease. CONCLUSIONS:This study identified the most robust markers of poor prognosis for COVID-19. These results can help to correctly stratify patients at the beginning of hospitalization based on the risk of developing severe disease.

SUBMITTER: Rodriguez-Molinero A

PROVIDER: S-EPMC7561079 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients.

Rodríguez-Molinero Alejandro A Gálvez-Barrón César C Miñarro Antonio A Macho Oscar O López Gabriela F GF Robles Maria Teresa MT Dapena María Dolores MD Martínez Sergi S Milà Ràfols Núria N Monaco Ernesto E EE Hidalgo García Antonio A

PloS one 20201015 10

<h4>Importance</h4>The rapid pandemic expansion of the disease caused by the new SARS-CoV-2 virus has compromised health systems worldwide. Knowledge of prognostic factors in affected patients can help optimize care.<h4>Objective</h4>The objective of this study was to analyze the relationship between the prognosis of COVID-19 and the form of presentation of the disease, the previous pathologies of patients and their chronic treatments.<h4>Design, participants and locations</h4>This was an observ ...[more]

PMID: 33057443

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Project description:BackgroundOlder adults from racial and ethnic minority groups are at higher risk for worse outcomes with COVID-19. This study sought to characterize the symptomatology of COVID-19 and the association of symptoms with all-cause in-hospital mortality and respiratory failure in a cohort of older, predominantly African American adults admitted to a tertiary hospital.MethodsA retrospective chart review of all hospitalized patients 65 and older with a positive SARS-CoV-2 test was conducted in a 953-bed academic, urban hospital. Measurements included demographics, symptoms, laboratory findings, and outcomes. The primary outcome was in-hospital mortality, and the secondary outcome was respiratory failure.ResultsA total of 134 patients with a mean age of 76.4 years were studied. Fifty-six percent were men and 90% were African American. Of these, 108 patients presented with typical symptoms, among whom 89.8% had co-existing geriatric syndromes. Only 10.2% presented with typical symptoms alone. The most common typical symptoms were fever (57%), shortness of breath (SOB) (51.2%), and cough (48.8%). Atypical symptoms were present in 68 (51%) patients, of whom 83.8% had co-existing typical symptoms and 76.5% had co-existing geriatric syndromes. Only 17.2% of patients presented with atypical symptoms alone. Atypical symptoms identified were anorexia (43%), dizziness (12.4%), and syncope (7.4%). Geriatric syndromes were identified in 102 (76%) patients, including altered mental status (71.1%), weakness (26.4%), and falls (24.8%). Respiratory failure occurred in 65.8% of patients, with 35.4% requiring ventilators while 22.3% of patients died. Age, male gender, SOB, sepsis, and certain laboratory values were associated with outcomes.ConclusionHospitalized older adults infected with SARS-CoV-2 may present with a range of symptoms encompassing typical, atypical, and geriatric syndromes. Early testing for COVID-19 should be considered in hospitalized older adults.

Project description:BackgroundThe coronavirus disease 19 (COVID-19) pandemic has spread rapidly around the globe with considerable morbidity and mortality. Coexistence of comorbidities with COVID-19 had consistently been reported as risk factors for unfavorable outcome. We aimed to evaluate the impact of comorbidities in COVID-19 patients on the outcome and determine predictors of prolonged hospital stay, requisite for intensive care unit (ICU) admission. Four hundred and thirty-nine adult patients who are admitted through (June and July 2020) in our University Hospitals were included in the study. All participants were diagnosed with COVID-19 according to Egyptian Ministry of Health guidance as definite case or probable case.ResultsPatients with comorbidities represented 61.7% of all cases. Constitutional symptoms especially myalgia and lower respiratory tract (LRT) symptoms such as dyspnea were significantly higher in patients with comorbidities (P < 0.05). Patients with comorbidities had significantly worse laboratory parameters. ICU admission was higher in patients with comorbidities (35.8%). Among different comorbidities 45.4% of cardiovascular diseases (CVD) cases were admitted in ICU followed by diabetes mellitus (DM) cases (40.8%). Also, patients with comorbidities needed invasive mechanical ventilation more than those without comorbidity (31 versus 10.7%, P < 0.001). Significant lower frequency of recovery was found in COVID-19 patients with comorbidities (59% versus 81%, P < 0.001) and death rate was significantly higher in cases with comorbidities (P < 0.001) . The survival rates in cases with pre-existing CVD and neurological diseases were lower than those without disease (P < 0.002 and 0.001, respectively).ConclusionsAssociation of cardiovascular comorbid conditions including hypertension or neurological diseases including old cerebrovascular strokes together with COVID-19 infections carries higher risks of mortality. However, other comorbidities such as diabetes mellitus, chronic pulmonary or kidney diseases may also contribute to increased COVID-19 severity.

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Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients.

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Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients.

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