Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II)
OBJECTIVES: COVID-19 may show no peculiar signs and symptoms that may differentiate it from other infective or non-infective etiologies; thus, early recognition and prompt management are crucial to improve survival. The aim of this study was to describe clinical, laboratory, and radiological characteristics and outcomes of hospitalized COVID-19 patients compared to those with other infective or non-infective etiologies.
METHODS: We performed a prospective study from March 2020 to February 2021. All patients hospitalized for suspected or confirmed COVID-19 were prospectively recruited. All patients were evaluated according to a predefined protocol for diagnosis of suspected SARS-CoV-2 infection. The primary endpoint was evaluation of clinical, laboratory, and radiological characteristics associated or not with COVID-19 etiology at time of hospitalization in an emergency department.
RESULTS: A total of 1036 patients were included in the study: 717 (69%) patients with confirmed COVID-19 and 319 (31%) without COVID-19, hospitalized for other causes. The main causes of hospitalization among non-COVID-19 patients were acute heart failure (44%) and bacterial pneumonia (45.8%). Overall, 30-day mortality was 9% among the COVID-19 group and 35% in the non-COVID-19 group. Multivariate analysis showed variables (fever > 3 days, dry cough, acute dyspnea, lymphocytes < 1000 × 103/µL, and ferritin > 250 ng/mL) independently associated with COVID-19 etiology. A decision tree was elaborated to early detect COVID-19 patients in the emergency department. Finally, Kaplan-Meier curves on 30-day survival in COVID-19 patients during the first wave (March-May 2020, n = 289 patients) and the second wave (October-February 2021, n = 428 patients) showed differences between the two study periods (p = 0.021).
CONCLUSIONS: Patients with confirmed diagnosis of COVID-19 may show peculiar characteristics at time of hospitalization that could help physicians to distinguish from other infective or non-infective etiologies. Finally, a different 30-day mortality rate was observed during different periods of the pandemic.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Diagnostics (Basel, Switzerland) - 11(2021), 8 vom: 29. Juli |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Russo, Alessandro [VerfasserIn] |
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| Links: |
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| Themen: |
Acute respiratory failure |
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| Anmerkungen: |
Date Revised 30.08.2021 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/diagnostics11081368 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM329842110 |
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| 500 | |a Date Revised 30.08.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a OBJECTIVES: COVID-19 may show no peculiar signs and symptoms that may differentiate it from other infective or non-infective etiologies; thus, early recognition and prompt management are crucial to improve survival. The aim of this study was to describe clinical, laboratory, and radiological characteristics and outcomes of hospitalized COVID-19 patients compared to those with other infective or non-infective etiologies | ||
| 520 | |a METHODS: We performed a prospective study from March 2020 to February 2021. All patients hospitalized for suspected or confirmed COVID-19 were prospectively recruited. All patients were evaluated according to a predefined protocol for diagnosis of suspected SARS-CoV-2 infection. The primary endpoint was evaluation of clinical, laboratory, and radiological characteristics associated or not with COVID-19 etiology at time of hospitalization in an emergency department | ||
| 520 | |a RESULTS: A total of 1036 patients were included in the study: 717 (69%) patients with confirmed COVID-19 and 319 (31%) without COVID-19, hospitalized for other causes. The main causes of hospitalization among non-COVID-19 patients were acute heart failure (44%) and bacterial pneumonia (45.8%). Overall, 30-day mortality was 9% among the COVID-19 group and 35% in the non-COVID-19 group. Multivariate analysis showed variables (fever > 3 days, dry cough, acute dyspnea, lymphocytes < 1000 × 103/µL, and ferritin > 250 ng/mL) independently associated with COVID-19 etiology. A decision tree was elaborated to early detect COVID-19 patients in the emergency department. Finally, Kaplan-Meier curves on 30-day survival in COVID-19 patients during the first wave (March-May 2020, n = 289 patients) and the second wave (October-February 2021, n = 428 patients) showed differences between the two study periods (p = 0.021) | ||
| 520 | |a CONCLUSIONS: Patients with confirmed diagnosis of COVID-19 may show peculiar characteristics at time of hospitalization that could help physicians to distinguish from other infective or non-infective etiologies. Finally, a different 30-day mortality rate was observed during different periods of the pandemic | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a acute respiratory failure | |
| 650 | 4 | |a decision tree | |
| 650 | 4 | |a fever | |
| 650 | 4 | |a mortality | |
| 700 | 1 | |a Gentilini Cacciola, Elio |e verfasserin |4 aut | |
| 700 | 1 | |a Borrazzo, Cristian |e verfasserin |4 aut | |
| 700 | 1 | |a Filippi, Valeria |e verfasserin |4 aut | |
| 700 | 1 | |a Bucci, Tommaso |e verfasserin |4 aut | |
| 700 | 1 | |a Vullo, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Celani, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Binetti, Erica |e verfasserin |4 aut | |
| 700 | 1 | |a Battistini, Luigi |e verfasserin |4 aut | |
| 700 | 1 | |a Ceccarelli, Giancarlo |e verfasserin |4 aut | |
| 700 | 1 | |a Alessandroni, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Galardo, Gioacchino |e verfasserin |4 aut | |
| 700 | 1 | |a Mastroianni, Claudio Maria |e verfasserin |4 aut | |
| 700 | 1 | |a d'Ettorre, Gabriella |e verfasserin |4 aut | |
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