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| Item Type: | Article |
|---|---|
| Title: | 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: a prospective observational study |
| Creators Name: | Thibeault, C. and Mühlemann, B. and Helbig, E.T. and Mittermaier, M. and Lingscheid, T. and Tober-Lau, P. and Meyer-Arndt, L.A. and Meiners, L. and Stubbemann, P. and Haenel, S.S. and Bosquillon de Jarcy, L. and Lippert, L. and Pfeiffer, M. and Stegemann, M.S. and Roehle, R. and Wiebach, J. and Hippenstiel, S. and Zoller, T. and Müller-Redetzky, H. and Uhrig, A. and Balzer, F. and von Kalle, C. and Suttorp, N. and Jones, T.C. and Drosten, C. and Witzenrath, M. and Sander, L.E. and Corman, V.M. and Kurth, F. |
| Abstract: | 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. |
| Keywords: | Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Coronavirus Disease 2019 (COVID-19), Viral Concentration, COVID-19 Nucleic Acid Testing, Respiratory Distress Syndrome, Mechanical Ventilation, Artificial Respiration, Prospective Study |
| Source: | Infection |
| ISSN: | 0300-8126 |
| Publisher: | Springer |
| Volume: | 49 |
| Number: | 4 |
| Page Range: | 703-714 |
| Date: | August 2021 |
| Official Publication: | https://doi.org/10.1007/s15010-021-01594-w |
| PubMed: | View item in PubMed |
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