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Research article
Anna Maria Cattelan
Azienda Ospedaliera di Padova
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2869-2945
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study aims to offer a comparative description of the COVID-19 patients, admitted to a general ward for a non-critical clinical picture, who required or not to be transferred to the intensive (ICU) and/or sub-intensive care (SICU) units.
Methods This observational retrospective study included all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined Group 1; patients who were transferred to the ICU and/or SICU are defined Group 2. Demographic and clinical characteristics were compared between the two groups.
Results 303 patients were included. Median age was 62 years. 69 patients (22,8%) met the primary outcome and were defined Group 2. The overall mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5% vs. 3,8%, p<0,01), had more hypertension (72,4% vs. 44%, p<0,01) and diabetes (31,9% vs. 21%, p=0,04) and were more likely to present dry cough (49,3% vs. 25,2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63,2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs. 17,2%, p<0,01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0,01).
Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.
Keywords
COVID-19, SARS-CoV-2, novel coronavirus, disease severity, outcome, intensive care, sub-intensive care
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CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 19 Nov, 2020
Editorial decision: Accept
On 18 Nov, 2020
Version 2
Posted 13 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 28 Oct, 2020
Review #2 received
Received 23 Oct, 2020
Reviewer #2 agreed
On 09 Oct, 2020
Review #1 received
Received 03 Oct, 2020
Reviewers invited
Invitations sent on 02 Oct, 2020
Reviewer #1 agreed
On 02 Oct, 2020
Editor assigned
On 01 Oct, 2020
Submission checks complete
On 30 Sep, 2020
Editor invited
On 30 Sep, 2020
No comments provided
Editorial decision: Major revision
On 07 Sep, 2020
Review #2 received
Received 03 Sep, 2020
Review #1 received
Received 26 Aug, 2020
Reviewer #2 agreed
On 17 Aug, 2020
Reviewer #1 agreed
On 30 Jul, 2020
Reviewers invited
Invitations sent on 26 Jul, 2020
Editor assigned
On 03 Jul, 2020
First submitted
On 02 Jul, 2020
Submission checks complete
On 02 Jul, 2020
Editor invited
On 02 Jul, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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A new preprint design is coming!
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Anna Maria Cattelan
Azienda Ospedaliera di Padova
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2869-2945
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 19 Nov, 2020
Editorial decision: Accept
On 18 Nov, 2020
Version 2
Posted 13 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 28 Oct, 2020
Review #2 received
Received 23 Oct, 2020
Reviewer #2 agreed
On 09 Oct, 2020
Review #1 received
Received 03 Oct, 2020
Reviewers invited
Invitations sent on 02 Oct, 2020
Reviewer #1 agreed
On 02 Oct, 2020
Editor assigned
On 01 Oct, 2020
Submission checks complete
On 30 Sep, 2020
Editor invited
On 30 Sep, 2020
No comments provided
Editorial decision: Major revision
On 07 Sep, 2020
Review #2 received
Received 03 Sep, 2020
Review #1 received
Received 26 Aug, 2020
Reviewer #2 agreed
On 17 Aug, 2020
Reviewer #1 agreed
On 30 Jul, 2020
Reviewers invited
Invitations sent on 26 Jul, 2020
Editor assigned
On 03 Jul, 2020
First submitted
On 02 Jul, 2020
Submission checks complete
On 02 Jul, 2020
Editor invited
On 02 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background Identifying risk factors for severe novel-coronavirus disease (COVID-19) is useful to ascertain which patients may benefit from advanced supportive care. The study aims to offer a comparative description of the COVID-19 patients, admitted to a general ward for a non-critical clinical picture, who required or not to be transferred to the intensive (ICU) and/or sub-intensive care (SICU) units.
Methods This observational retrospective study included all COVID-19 patients admitted to the Infectious Diseases Unit. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of need of transfer to the ICU and/or SICU during the hospitalization. Patients who did not require to be transferred are defined Group 1; patients who were transferred to the ICU and/or SICU are defined Group 2. Demographic and clinical characteristics were compared between the two groups.
Results 303 patients were included. Median age was 62 years. 69 patients (22,8%) met the primary outcome and were defined Group 2. The overall mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5% vs. 3,8%, p<0,01), had more hypertension (72,4% vs. 44%, p<0,01) and diabetes (31,9% vs. 21%, p=0,04) and were more likely to present dry cough (49,3% vs. 25,2%, p<0.01). Overall, chest X-ray at admission showed findings suggestive of pneumonia in 63,2%, and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs. 17,2%, p<0,01). At admission, Group 2 presented significantly higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3rd measurement, Group 2 presented persistently higher neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20 vs. 35 days, p<0,01).
Conclusions The presence of comorbidities and the persistent observation of abnormal laboratory findings should be regarded as predisposing factors for clinical worsening.
This is a list of supplementary files associated with this preprint. Click to download.
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