Russo, Alessandro, Cacciola, Elio Gentilini, Borrazzo, Cristian, Filippi, Valeria, Bucci, Tommaso 
ORCID: 0000-0003-2895-6234, Vullo, Francesco, Celani, Luigi, Binetti, Erica, Battistini, Luigi, Ceccarelli, Giancarlo et al (show 4 more authors)
(2021)
Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II).
DIAGNOSTICS, 11 (8).
1368-.
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Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II). .pdf - Published version Download (652kB) | Preview |
Abstract
<h4>Objectives</h4>COVID-19 may show no peculiar signs and symptoms that may differentiate it from other infective or non-infective etiologies; thus, early recognition and prompt management are crucial to improve survival. The aim of this study was to describe clinical, laboratory, and radiological characteristics and outcomes of hospitalized COVID-19 patients compared to those with other infective or non-infective etiologies.<h4>Methods</h4>We performed a prospective study from March 2020 to February 2021. All patients hospitalized for suspected or confirmed COVID-19 were prospectively recruited. All patients were evaluated according to a predefined protocol for diagnosis of suspected SARS-CoV-2 infection. The primary endpoint was evaluation of clinical, laboratory, and radiological characteristics associated or not with COVID-19 etiology at time of hospitalization in an emergency department.<h4>Results</h4>A total of 1036 patients were included in the study: 717 (69%) patients with confirmed COVID-19 and 319 (31%) without COVID-19, hospitalized for other causes. The main causes of hospitalization among non-COVID-19 patients were acute heart failure (44%) and bacterial pneumonia (45.8%). Overall, 30-day mortality was 9% among the COVID-19 group and 35% in the non-COVID-19 group. Multivariate analysis showed variables (fever > 3 days, dry cough, acute dyspnea, lymphocytes < 1000 × 10<sup>3</sup>/µL, and ferritin > 250 ng/mL) independently associated with COVID-19 etiology. A decision tree was elaborated to early detect COVID-19 patients in the emergency department. Finally, Kaplan-Meier curves on 30-day survival in COVID-19 patients during the first wave (March-May 2020, <i>n</i> = 289 patients) and the second wave (October-February 2021, <i>n</i> = 428 patients) showed differences between the two study periods (<i>p</i> = 0.021).<h4>Conclusions</h4>Patients with confirmed diagnosis of COVID-19 may show peculiar characteristics at time of hospitalization that could help physicians to distinguish from other infective or non-infective etiologies. Finally, a different 30-day mortality rate was observed during different periods of the pandemic.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SARS-CoV-2, COVID-19, decision tree, acute respiratory failure, fever, mortality |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 26 Oct 2022 08:34 |
| Last Modified: | 02 Feb 2024 11:52 |
| DOI: | 10.3390/diagnostics11081368 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3165763 |
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