Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: A comparison of patients with and without SARS-CoV-2 infection. Issue 6 (December 2020)

• Record Type: Journal Article
• Authors: Brendish, Nathan J; Poole, Stephen; Naidu, Vasanth V; Mansbridge, Christopher T; Norton, Nicholas; Borca, Florina; Phan, Hang TT; Wheeler, Helen; Harvey, Matthew; Presland, Laura; Clark, Tristan W
• Is Part Of: Journal of infection. Volume 81:Issue 6(2020)
• Page Start: 937
• Page End: 943
• Publication Date: 2020-12
• Subjects: COVID-19 -- SARS-CoV-2 -- Clinical characteristics -- Symptoms -- Cohort -- Outcomes -- Healthcare workers -- Smokers -- COPD; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2020.09.033
• Languages: English
• ISSNs: 0163-4453

Abstract

Highlights: We analysed data from 1054 hospitalised adults tested for SARS-CoV-2. COVID-19 patients less frequently were smokers or had COPD vs negative patients. Over a fifth of COVID-19 patients were healthcare workers vs <6% negative patients. About a third of COVID-19 patients reported anosmia vs <10% negative patients. COVID-19 patients had longer hospitalisation and invasive ventilation duration. Abstract: Objectives: Most reports describing the characteristics of patients hospitalised with COVID-19 lack a comparator group. We compared clinical characteristics, symptoms, and outcomes of adults presenting to hospital during the pandemic first wave, who tested positive and negative for SARS-CoV-2. Methods: Detailed patient data was obtained from a large, controlled, non-randomised trial of molecular point-of-care testing versus laboratory RT-PCR for SARS-CoV-2 in adults presenting to a large UK hospital with suspected COVID-19. Results: 1054 patients were included: 352 (33.4%) tested positive and 702 (66.6%) negative. 13.4% (47/352) COVID-19-positive patients had COPD versus 18.7% (131/702) of COVID-19-negative patients (difference=5.3% [95%CI −9.7% to −0.5%], p = 0.0297). 5.7% (20/352) of COVID-19-positive patients were smokers versus 16.5% (116/702) of negative patients (difference=−10.8% [−14.4% to −7.0%], p = 0.0001). 70.5% (248/352) of COVID-19-positive patients were White-British versus 85.5% (600/702) of negative patients (difference=−15.0% [−20.5% to −9.7%], p <0.0001). 20.9% (39/187) of COVID-19-positive patients were healthcare workers versus 5.2% (15/287) of negative patients ( p <0.0001). Anosmia was reported in 33.1% (47/142) versus 8.8% (19/216) of COVID-19-positive and negative patients respectively ( p <0.0001). Non-SARS-CoV-2 respiratory viruses or atypical bacteria were detected in 2.5% (5/197) of COVID-19 patients versus 7.9% (24/302) of COVID-19-negative patients ( p = 0.0109). Hospitalisation duration and 30-day-mortality were higher in COVID-19 patients and invasive ventilation was more frequent (11.1% vs 2.8%, p <0.0001), and longer (14.5 vs 4.7 days, p = 0.0015). Conclusions: There were substantial differences between patients with and without COVID-19 in terms of ethnicity, healthcare worker-status, comorbidities, symptoms, and outcomes. These data can inform healthcare planning for the next phase of the pandemic.