Early predictors of clinical deterioration in a cohort of outpatients with COVID‐19 in southern Italy: A multicenter observational study
Data regarding early predictors of clinical deterioration in patients with infection of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is still scarce. The aim of the study is to identify early symptoms or signs that may be associated with severe coronavirus disease 2019 (COVID‐19). We...
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| Veröffentlicht in: | Journal of medical virology 2022-11, Vol.94 (11), p.5336-5344 |
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| creator | Monari, Caterina Pisaturo, Mariantonietta Maggi, Paolo Macera, Margherita Di Caprio, Giovanni Pisapia, Raffaella Gentile, Valeria Fordellone, Mario Chiodini, Paolo Coppola, Nicola |
| description | Data regarding early predictors of clinical deterioration in patients with infection of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is still scarce. The aim of the study is to identify early symptoms or signs that may be associated with severe coronavirus disease 2019 (COVID‐19). We conducted a multicentre prospective cohort study on a cohort of patients with COVID‐19 in home isolation from March 2020 to April 2021. We assessed longitudinal clinical data (fever, dyspnea, need for hospitalization) through video calls at three specific time points: the beginning of symptoms or the day of the first positivity of the nasopharyngeal swab for SARS‐CoV‐2‐RNA (t0), and 3 (t3) and 7 (t7) days after the onset of symptoms. We included 329 patients with COVID‐19: 182 (55.3%) males, mean age 53.4 ± 17.4 years, median Charlson comorbidity index (CCI) of 1 (0–3). Of the 329 patients enrolled, 171 (51.98%) had a mild, 81 (24.6%) a moderate, and 77 (23.4%) a severe illness; 151 (45.9%) were hospitalized. Compared to patients with mild COVID‐19, moderate and severe patients were older (p |
| doi_str_mv | 10.1002/jmv.28007 |
| format | Article |
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The aim of the study is to identify early symptoms or signs that may be associated with severe coronavirus disease 2019 (COVID‐19). We conducted a multicentre prospective cohort study on a cohort of patients with COVID‐19 in home isolation from March 2020 to April 2021. We assessed longitudinal clinical data (fever, dyspnea, need for hospitalization) through video calls at three specific time points: the beginning of symptoms or the day of the first positivity of the nasopharyngeal swab for SARS‐CoV‐2‐RNA (t0), and 3 (t3) and 7 (t7) days after the onset of symptoms. We included 329 patients with COVID‐19: 182 (55.3%) males, mean age 53.4 ± 17.4 years, median Charlson comorbidity index (CCI) of 1 (0–3). Of the 329 patients enrolled, 171 (51.98%) had a mild, 81 (24.6%) a moderate, and 77 (23.4%) a severe illness; 151 (45.9%) were hospitalized. Compared to patients with mild COVID‐19, moderate and severe patients were older (p < 0.001) and had more comorbidities, especially hypertension (p < 0.001) and cardiovascular diseases (p = 0.01). At t3 and t7, we found a significant higher rate of persisting fever (≥37°C) among patients with moderate (91.4% and 58.0% at t3 and t7, respectively; p < 0.001) and severe outcome (75.3% and 63.6%, respectively; p < 0.001) compared to mild COVID‐19 outcome (27.5% and 11.7%, respectively; p < 0.001). Factors independently associated with a more severe outcome were persisting fever at t3 and t7, increasing age, and CCI above 2 points. Persisting fever at t3 and t7 seems to be related to a more severe COVID‐19. This data may be useful to assess hospitalization criteria and optimize the use of resources in the outpatient setting.</description><identifier>ISSN: 0146-6615</identifier><identifier>ISSN: 1096-9071</identifier><identifier>EISSN: 1096-9071</identifier><identifier>DOI: 10.1002/jmv.28007</identifier><identifier>PMID: 35854433</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Cardiovascular diseases ; Clinical Deterioration ; Cohort Studies ; Comorbidity ; Coronaviruses ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; Dyspnea ; early predictors ; Female ; Fever ; Fever - epidemiology ; Hospitalization ; Humans ; Hypertension ; Male ; Middle Aged ; Observational studies ; Outpatients ; Patients ; Prospective Studies ; Respiration ; SARS-CoV-2 ; SARS‐CoV‐2 infection ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; severe outcome ; Signs and symptoms ; Viral diseases ; Virology ; Vital signs</subject><ispartof>Journal of medical virology, 2022-11, Vol.94 (11), p.5336-5344</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC.</rights><rights>2022 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3187-4ccb92ec20e9c484d23460e2ccf09616efda627843a0e10a453005fa1117764e3</citedby><cites>FETCH-LOGICAL-c3187-4ccb92ec20e9c484d23460e2ccf09616efda627843a0e10a453005fa1117764e3</cites><orcidid>0000-0001-5897-4949</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmv.28007$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmv.28007$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35854433$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Monari, Caterina</creatorcontrib><creatorcontrib>Pisaturo, Mariantonietta</creatorcontrib><creatorcontrib>Maggi, Paolo</creatorcontrib><creatorcontrib>Macera, Margherita</creatorcontrib><creatorcontrib>Di Caprio, Giovanni</creatorcontrib><creatorcontrib>Pisapia, Raffaella</creatorcontrib><creatorcontrib>Gentile, Valeria</creatorcontrib><creatorcontrib>Fordellone, Mario</creatorcontrib><creatorcontrib>Chiodini, Paolo</creatorcontrib><creatorcontrib>Coppola, Nicola</creatorcontrib><creatorcontrib>CoviCam Group</creatorcontrib><title>Early predictors of clinical deterioration in a cohort of outpatients with COVID‐19 in southern Italy: A multicenter observational study</title><title>Journal of medical virology</title><addtitle>J Med Virol</addtitle><description>Data regarding early predictors of clinical deterioration in patients with infection of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is still scarce. The aim of the study is to identify early symptoms or signs that may be associated with severe coronavirus disease 2019 (COVID‐19). We conducted a multicentre prospective cohort study on a cohort of patients with COVID‐19 in home isolation from March 2020 to April 2021. We assessed longitudinal clinical data (fever, dyspnea, need for hospitalization) through video calls at three specific time points: the beginning of symptoms or the day of the first positivity of the nasopharyngeal swab for SARS‐CoV‐2‐RNA (t0), and 3 (t3) and 7 (t7) days after the onset of symptoms. We included 329 patients with COVID‐19: 182 (55.3%) males, mean age 53.4 ± 17.4 years, median Charlson comorbidity index (CCI) of 1 (0–3). Of the 329 patients enrolled, 171 (51.98%) had a mild, 81 (24.6%) a moderate, and 77 (23.4%) a severe illness; 151 (45.9%) were hospitalized. Compared to patients with mild COVID‐19, moderate and severe patients were older (p < 0.001) and had more comorbidities, especially hypertension (p < 0.001) and cardiovascular diseases (p = 0.01). At t3 and t7, we found a significant higher rate of persisting fever (≥37°C) among patients with moderate (91.4% and 58.0% at t3 and t7, respectively; p < 0.001) and severe outcome (75.3% and 63.6%, respectively; p < 0.001) compared to mild COVID‐19 outcome (27.5% and 11.7%, respectively; p < 0.001). Factors independently associated with a more severe outcome were persisting fever at t3 and t7, increasing age, and CCI above 2 points. Persisting fever at t3 and t7 seems to be related to a more severe COVID‐19. 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The aim of the study is to identify early symptoms or signs that may be associated with severe coronavirus disease 2019 (COVID‐19). We conducted a multicentre prospective cohort study on a cohort of patients with COVID‐19 in home isolation from March 2020 to April 2021. We assessed longitudinal clinical data (fever, dyspnea, need for hospitalization) through video calls at three specific time points: the beginning of symptoms or the day of the first positivity of the nasopharyngeal swab for SARS‐CoV‐2‐RNA (t0), and 3 (t3) and 7 (t7) days after the onset of symptoms. We included 329 patients with COVID‐19: 182 (55.3%) males, mean age 53.4 ± 17.4 years, median Charlson comorbidity index (CCI) of 1 (0–3). Of the 329 patients enrolled, 171 (51.98%) had a mild, 81 (24.6%) a moderate, and 77 (23.4%) a severe illness; 151 (45.9%) were hospitalized. Compared to patients with mild COVID‐19, moderate and severe patients were older (p < 0.001) and had more comorbidities, especially hypertension (p < 0.001) and cardiovascular diseases (p = 0.01). At t3 and t7, we found a significant higher rate of persisting fever (≥37°C) among patients with moderate (91.4% and 58.0% at t3 and t7, respectively; p < 0.001) and severe outcome (75.3% and 63.6%, respectively; p < 0.001) compared to mild COVID‐19 outcome (27.5% and 11.7%, respectively; p < 0.001). Factors independently associated with a more severe outcome were persisting fever at t3 and t7, increasing age, and CCI above 2 points. Persisting fever at t3 and t7 seems to be related to a more severe COVID‐19. This data may be useful to assess hospitalization criteria and optimize the use of resources in the outpatient setting.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35854433</pmid><doi>10.1002/jmv.28007</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5897-4949</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Cardiovascular diseases Clinical Deterioration Cohort Studies Comorbidity Coronaviruses COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology Dyspnea early predictors Female Fever Fever - epidemiology Hospitalization Humans Hypertension Male Middle Aged Observational studies Outpatients Patients Prospective Studies Respiration SARS-CoV-2 SARS‐CoV‐2 infection Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 severe outcome Signs and symptoms Viral diseases Virology Vital signs |
| title | Early predictors of clinical deterioration in a cohort of outpatients with COVID‐19 in southern Italy: A multicenter observational study |
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