Symptoms at disease onset predict prognosis in COVID-19 disease

Libyan Journal of Medicine

article

Aiyuan Zhou¹  Qing Song⁶  Yating Peng⁶  Xin Liao⁷  Peng Huang⁸  Wenlong Liu⁹  Zhi Xiang^1,10  Qimi Liu^1,11  Mingyan Jiang^1,12  Xudong Xiang^1,13  Dingding Deng^1,14  Ping Chen⁶ 

[1] Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University;Center of Respiratory Medicine, Xiangya Hospital, Central South University;Clinical Research Center for Respiratory Diseases in Hunan Province;Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease;National Clinical Research Center for Geriatric Disorders, Xiangya Hospital;Department of Respiratory and Critical Medicine, the Second Xiangya Hospital, Central South University;Department of Respiratory Medicine, Affiliated Shaoyang Central Hospital of University of South China;Department of Respiratory Medicine, Zhuzhou Central Hospital;Department of Respiratory Medicine, Yueyang Second People’s Hospital, Designated Hospital of Junshan District;Department of Respiratory Medicine, the First People’s Hospital of Huaihua affiliated to University of South China;Department of Respiratory Medicine, the Second People’s Hospital of Guilin;Department of Respiratory and Critical Medicine, Xiangtan Central Hospital;Department of Emergency Medicine, Second Xiangya Hospital, Central South University;Department of Respiratory Medicine, The first Attached Hospital of Shaoyang University

关键词: COVID-19;    SARS-CoV-2;    ARDS;    symptoms;    outcome;   

DOI  :  10.1080/19932820.2021.2010338

学科分类：社会科学、人文和艺术（综合）

来源: Co-Action Publishing

【 摘 要 】

The main clinical manifestations of coronavirus disease 2019 (COVID-19) onset are respiratory symptoms, including cough, sputum, and dyspnea.  However, a significant proportion of patients initially manifested non-respiratory symptoms, such as fever, myalgia, and diarrhea. Here, we  compared the different characteristics and outcomes between the patients with respiratory symptoms and non-respiratory symptoms at illness  onset. The patients admitted to the respiratory departments from eight hospitals in Hunan and Guangxi Province with nucleic acid-positive severe  acute respiratory syndrome coronavirus (SARS-CoV-2) were recruited. Epidemiological information, clinical manifestations, laboratory findings, and  radiological characteristics, treatment regimens, and outcomes data were recorded and analyzed. The median age of the recruited 541 subjects was  43 years (IQR, 33–55). Of the 541 subjects, 404 (74.5%) subjects had initial symptom that were respiratory, while 137 (25.5%) subjects had non-  respiratory symptoms. Respiratory COVID-19 subjects had more secondary bacterial infections (8.7% vs 0.0%, P < 0.001), needed the intensive care  unit more (9.7% vs 2.2%, P = 0.005), non-invasive ventilation more (7.2% vs 1.5%, P = 0.004), developed ARDS more (11.4% vs 2.2%, P = 0.001) and  needed longer time to recover (18.5 vs 16.7 days, P = 0.003) compared to predominately non-respiratory COVID-19 subjects. The multivariate model  showed that age (OR = 1.04, P = 0.01), dyspnea (OR = 4.91, P < 0.001) and secondary bacterial infection (OR = 19.8, P < 0.001) were independently  associated with development of ARDS among COVID-19 patients. We identify COVID-19 subjects with dyspnea at disease onset who have a worse  prognosis. We also demonstrate age and secondary bacterial infections to be independently associated with ARDS development in subjects with  COVID-19.

【 授权许可】

CC BY|CC BY-NC