Direct Comparison of Clinical Characteristics, Outcomes, and Risk Prediction in Patients with COVID-19 and Controls—A Prospective Cohort Study

Journal of Clinical Medicine

Maurin Lampart¹  Stefan Osswald¹  Ceylan Eken¹  Gabriela M. Kuster¹  Raphael Tweenhood¹  Sarah Tschudin-Sutter²  Stefano Bassetti³  Roland Bingisser⁴  Andrea S. Jauslin⁴  Christian H. Nickel⁴  Noemi R. Simon⁴  Marco Rüegg⁴  Núria Zellweger⁵  Martin Siegemund⁵  Katharina M. Rentsch⁶ 

[1] Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland;Division of Internal Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland;Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland;Intensive Care Unit, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland;Laboratory Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland;

关键词: COVID-19;    SARS-CoV-2;    characteristics;    outcome;    comparison;    risk prediction;   

DOI  :  10.3390/jcm10122672

来源: DOAJ

【 摘 要 】

Most studies investigating early risk predictors in coronavirus disease 19 (COVID-19) lacked comparison with controls. We aimed to assess and directly compare outcomes and risk predictors at time of emergency department (ED) presentation in COVID-19 and controls. Consecutive patients presenting to the ED with suspected COVID-19 were prospectively enrolled. COVID-19-patients were compared with (i) patients tested negative (overall controls) and (ii) patients tested negative, who had a respiratory infection (respiratory controls). Primary outcome was the composite of intensive care unit (ICU) admission and death at 30 days. Among 1081 consecutive cases, 191 (18%) were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 890 (82%) were tested negative (overall controls), of which 323 (30%) had a respiratory infection (respiratory controls). Incidence of the composite outcome was significantly higher in COVID-19 (23%) as compared with the overall control group (10%, adjusted-HR 2.45 (95%CI, 1.61–3.74), p < 0.001) or the respiratory control group (10%, adjusted-HR 2.93 (95%CI, 1.66–5.17), p < 0.001). Blood oxygen saturation, age, high-sensitivity troponin, c-reactive protein, and lactate dehydrogenase were identified as the strongest predictors of poor outcome available at time of ED presentation in COVID-19 with highly comparable prognostic utility in overall and respiratory controls. In conclusion, patients presenting to the ED with COVID-19 have a worse outcome than controls, even after adjustment for differences in baseline characteristics. Most predictors of poor outcome in COVID-19 were not restricted to COVID-19, but of comparable prognostic utility in controls and therefore generalizable to unselected patients with suspected COVID-19.

【 授权许可】

Unknown