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Deprecated: Implicit conversion from float 298.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 EClinicalMedicine 2020 ; 27 (ä): 100518 Nephropedia Template TP
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Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: A retrospective cohort study of patients with and without COVID-19 #MMPMID32864588
Shah SJ; Barish PN; Prasad PA; Kistler A; Neff N; Kamm J; Li LM; Chiu CY; Babik JM; Fang MC; Abe-Jones Y; Alipanah N; Alvarez FN; Botvinnik OB; Castaneda G; Dadasovich RM; Davis J; Deng X; DeRisi JL; Detweiler AM; Federman S; Haliburton J; Hao S; Kerkhoff AD; Kumar GR; Malcolm KB; Mann SA; Martinez S; Mary RK; Mick E; Mwakibete L; Najafi N; Peluso MJ; Phelps M; Pisco AO; Ratnasiri K; Rubio LA; Sellas A; Sherwood KD; Sheu J; Spottiswoode N; Tan M; Yu G; Kangelaris KN; Langelier C
EClinicalMedicine 2020[Oct]; 27 (ä): 100518 PMID32864588show ga
BACKGROUND: Most data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have been presented as case series without comparison to patients with other acute respiratory illnesses. METHODS: We examined emergency department patients between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared clinical presentation, diagnostics, treatment, and outcomes. FINDINGS: Among 316 patients, 33 tested positive for SARS-CoV-2; 31 without COVID-19 tested positive for another respiratory virus. Among patients with additional viral testing (27/33), no SARS-CoV-2 co-infections were identified. Compared to those who tested negative, patients with COVID-19 reported longer symptoms duration (median 7d vs. 3d, p < 0.001). Patients with COVID-19 were more often hospitalized (79% vs. 56%, p = 0.014). When hospitalized, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p < 0.001) and more often developed ARDS (23% vs. 3%, p < 0.001). Most comorbidities, medications, symptoms, vital signs, laboratories, treatments, and outcomes did not differ by COVID-19 status. INTERPRETATION: While we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections. FUNDING: National Center for Advancing Translational Sciences, National Heart Lung Blood Institute, National Institute of Allergy and Infectious Diseases, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative.