Association Between Clinical Characteristics and Short-Term Outcomes in Adult Male COVID-19 Patients With Mild Clinical Symptoms: A Single-Center Observational Study

Bailing Yan, Lei Song, Jia Guo, Yangyang Wang, Liping Peng, Dan Li, Bailing Yan, Lei Song, Jia Guo, Yangyang Wang, Liping Peng, Dan Li

Abstract

Majority of patients with 2019 novel coronavirus infection (COVID-19) exhibit mild symptoms. Identification of COVID-19 patients with mild symptoms who might develop into severe or critical illness is essential to save lives. We conducted an observational study in a dedicated make-shift hospital for adult male COVID-19 patients with mild symptoms between February and March 2020. Baseline characteristics, medical history, and clinical presentation were recorded. Laboratory tests and chest computed tomography were performed. Patients were observed until they were either transferred to a hospital for advanced care owing to disease exacerbation or were discharged after improvement. Patients were grouped based on their chest imaging findings or short-term outcomes. A total of 125 COVID-19 patients with mild symptoms were enrolled. Of these, 7 patients were transferred for advanced care while 118 patients were discharged after improvement and showed no disease recurrence during an additional 28-day follow-up period. Eighty-five patients (68.0%) had abnormal chest imaging findings. Patients with abnormal chest imaging findings were more likely to have disease deterioration and require advanced care as compared to those with normal chest imaging findings. Patients with deteriorated outcomes were more likely to have low peripheral blood oxygen saturation and moderately-elevated body temperature. There were no significant differences between patients with deteriorated or improved outcomes with respect to age, comorbidities, or other clinical symptoms (including nasal congestion, sore throat, cough, hemoptysis, sputum production, shortness of breath, fatigue, headache, nausea or vomiting, diarrhea). Abnormal chest imaging findings, low peripheral blood oxygen saturation, and elevated temperature were associated with disease deterioration in adult male COVID-19 patients with mild clinical symptoms. Clinical Trial Registration: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009RA3&selectaction=Edit&uid=U0003F4L&ts=2&cx=-ajpsbw, identifier NCT04346602.

Keywords: COVID-19; chest imaging study; mobile cabin hospital; observational study; peripheral blood oxygen saturation.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Yan, Song, Guo, Wang, Peng and Li.

References

    1. Ge H, Wang X, Yuan X, Xiao G, Wang C, Deng T. The epidemiology and clinical information about COVID-19. Eur. J. Clin. Microbiol. Infect. Dis. (2020) 39:1–9. 10.1007/s10096-020-03874-z
    1. Coronaviridae Study Group of the International Committee on Taxonomy of Viruses . The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol. (2020) 5:536–44. 10.1038/s41564-020-0695-z
    1. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. (2020) 91:157–60. 10.23750/abm.v91i1.9397
    1. Hassan SA, Sheikh FN, Jamal S, Ezeh JK, Akhtar A. Coronavirus (COVID-19): a review of clinical features, diagnosis, and treatment. Cureus. (2020) 12:e7355. 10.7759/cureus.7355
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. (2020) 395:497–506. 10.1016/S0140-6736(20)30183-5
    1. Zhou Y, Zhang Z, Tian J, Xiong S. Risk factors associated with disease progression in a cohort of patients infected with the 2019 novel coronavirus. Ann. Palliat. Med. (2020) 9:428–36. 10.21037/apm.2020.03.26
    1. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. (2020) 323:1061–9. 10.1001/jama.2020.1585
    1. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, et al. . Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. (2020) 323:2052–9. 10.1001/jama.2020.6775
    1. Gandhi RT, Lynch JBC. Del Rio. Mild or moderate Covid-19. N. Engl. J. Med. (2020) 383:1757–66. 10.1056/NEJMcp2009249
    1. Yao W, Wang X, Liu T. Critical role of Wuhan cabin hospital in controlling local COVID-19 pandemic. Infect. Control Hosp. Epidemiol. (2020) 41:1356–8. 10.1017/ice.2020.167
    1. Sun C, Wu Q, Zhang C. Managing patients with COVID-19 infections: a first-hand experience from the Wuhan mobile cabin hospital. Br. J. Gen. Pract. (2020) 70:229–30. 10.3399/bjgp20X709529
    1. Shu L, Ji N, Chen X, Feng G. Ark of life and hope: the role of the cabin hospital in facing COVID-19. J. Hosp. Infect. (2020) 105:351–2. 10.1016/j.jhin.2020.03.032
    1. Acikgoz O, Gunay A. The early impact of the Covid-19 pandemic on the global and Turkish economy. Turk. J. Med. Sci. (2020) 50:520–6. 10.3906/sag-2004-6
    1. Ayittey FK, Ayittey MK, Chiwero NB, Kamasah JS, Dzuvor C. Economic impacts of Wuhan 2019-nCoV on China and the world. J. Med. Virol. (2020) 92:473–5. 10.1002/jmv.25706
    1. Trilla A. One world, one health: the novel coronavirus COVID-19 epidemic. Med. Clin. (2020) 154:175–7. 10.1016/j.medcle.2020.02.001
    1. Wu X, Chen Y, Cai J, Xia X, Zhou S, Xu H, et al. . Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA. Intern. Med. (2020) 180:934–43. 10.1001/jamainternmed.2020.0994
    1. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. (2020) 395:1054–62. 10.1016/S0140-6736(20)30566-3
    1. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. (2020) 395:507–13. 10.1016/S0140-6736(20)30211-7
    1. CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb. Mortal. Wkly. Rep. (2020) 69:343–6. 10.15585/mmwr.mm6912e2
    1. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. . Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. (2020) 368:m1091. 10.1136/bmj.m1091
    1. Vincent JL, Taccone FS. Understanding pathways to death in patients with COVID-19. Lancet Respir. Med. (2020) 8:430–2. 10.1016/S2213-2600(20)30165-X
    1. Meng H, Xiong R, He R, Lin W, Hao B, Zhang L, et al. . CT imaging and clinical course of asymptomatic cases with COVID-19 pneumonia at admission in Wuhan, China. J. Infect. (2020) 81:e33–9. 10.1016/j.jinf.2020.04.004
    1. Smallwood CD, Walsh BK. Noninvasive monitoring of oxygen and ventilation. Respir. Care. (2017) 62:751–64. 10.4187/respcare.05243
    1. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N. Engl. J. Med. (2020) 382:1708–20. 10.1056/NEJMoa2002032
    1. Liu Y, Liao W, Wan L, Xiang T, Zhang W. Correlation between relative nasopharyngeal virus RNA load and lymphocyte count disease severity in patients with COVID-19. Viral Immunol. (2020). 10.1089/vim.2020.0062
    1. Shi Y, Wang Y, Shao C, Huang J, Gan J, Huang X, et al. . COVID-19 infection: the perspectives on immune responses. Cell Death Differ. (2020) 27:1451–4. 10.1038/s41418-020-0530-3
    1. Petretto DR, Pili R. Ageing and COVID-19: what is the role for elderly people? Geriatrics. (2020) 5:25. 10.3390/geriatrics5020025
    1. Tian S, Xiong Y, Liu H, Niu L, Guo J, Liao M. Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies. Mod. Pathol. (2020) 33:1007–14. 10.20944/preprints202003.0311.v1
    1. Yan B, Song L, Guo J, Wang Y, Peng L, Li D. Association between clinical characteristics and short-term outcomes in adult male COVID-19 patients with mild clinical symptoms: a single-center observational study. Preprint. (2020). 10.21203/-29526/v1

Source: PubMed

3
Abonnieren