TY - JOUR
T1 - Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic
T2 - a prospective observational study
AU - Thibeault, Charlotte
AU - Mühlemann, Barbara
AU - Helbig, Elisa T.
AU - Mittermaier, Mirja
AU - Lingscheid, Tilman
AU - Tober-Lau, Pinkus
AU - Meyer-Arndt, Lil A.
AU - Meiners, Leonie
AU - Stubbemann, Paula
AU - Haenel, Sascha S.
AU - Bosquillon de Jarcy, Laure
AU - Lippert, Lena
AU - Pfeiffer, Moritz
AU - Stegemann, Miriam S.
AU - Roehle, Robert
AU - Wiebach, Janine
AU - Hippenstiel, Stefan
AU - Zoller, Thomas
AU - Müller-Redetzky, Holger
AU - Uhrig, Alexander
AU - Balzer, Felix
AU - von Kalle, Christof
AU - Suttorp, Norbert
AU - Jones, Terry C.
AU - Drosten, Christian
AU - Witzenrath, Martin
AU - Sander, Leif E.
AU - Jürgens, Linda
AU - Kleinschmidt, Malte
AU - Denker, Sophy
AU - Ruwwe-Glösenkamp, Christoph
AU - Temmesfeld-Wollbrück, Bettina
AU - Heim, Katrin M.
AU - Schürmann, Dirk
AU - Hocke, Andreas
AU - Opitz, Bastian
AU - Pascual-Leone, Belén Millet
AU - Schuhmacher, Rosa C.
AU - Olk, Nadine
AU - Hillus, David
AU - Machleidt, Felix
AU - Albus, Sebastian
AU - Bremer, Felix
AU - Doehn, Jan Moritz
AU - Garcia, Carmen
AU - Knape, Philipp
AU - Krause, Philipp M.
AU - Lechtenberg, Liron
AU - Li, Yaosi
AU - Pergantis, Panagiotis
AU - Pa-COVID Study Group
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/8
Y1 - 2021/8
N2 - Purpose: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course. Methods: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed. Results: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10–1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00–16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26–46.75, vs 18 days, IQR 16–46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6–15.5) for non-IMV and 49.5 days (IQR 36.8–82.5) for IMV patients. Conclusions: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19.
AB - Purpose: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course. Methods: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed. Results: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10–1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00–16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26–46.75, vs 18 days, IQR 16–46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6–15.5) for non-IMV and 49.5 days (IQR 36.8–82.5) for IMV patients. Conclusions: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19.
KW - Artificial respiration
KW - Coronavirus disease 2019 (COVID-19)
KW - COVID-19 nucleic acid testing
KW - Mechanical ventilation
KW - Prospective study
KW - Respiratory distress syndrome
KW - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
KW - Symptom assessment
KW - Viral concentration
UR - http://www.scopus.com/inward/record.url?scp=85105048359&partnerID=8YFLogxK
U2 - 10.1007/s15010-021-01594-w
DO - 10.1007/s15010-021-01594-w
M3 - Article
C2 - 33890243
AN - SCOPUS:85105048359
SN - 0300-8126
VL - 49
SP - 703
EP - 714
JO - Infection
JF - Infection
IS - 4
ER -