Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection and Definitions
2.2. Main Outcome Measures
2.3. Microbiology
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Non-COVID-19 n = 319 | COVID-19 n = 717 | p-Value |
---|---|---|---|
Male sex | 199 (62%) | 446 (62%) | 0.956 |
Age (years), median (IQR: 25–75%) ± SD | 75.3 ± 14.4 | 64.1 ± 17.1 | <0.001 |
Days from symptoms to RT-PCR test, median (IQR: 25–75%) | 2 (1–5) | 4 (1–7) | 0.002 |
Coexisting comorbidities, n (%) | 286 (89.6%) | 206 (28.7%) | <0.001 |
Cardiovascular disease, n (%) | 248 (78%) | 57 (8%) | <0.001 |
COPD, n (%) | 163 (51%) | 60 (8%) | <0.001 |
Chronic renal disease, n (%) | 100 (31%) | 37 (5%) | <0.001 |
Cirrhosis, n (%) | 64 (20%) | 17 (2%) | <0.001 |
Diabetes, n (%) | 27 (8%) | 77 (11%) | <0.001 |
Solid lung cancer, n (%) | 61 (19%) | 6 (1%) | <0.001 |
Clinical features and radiological findings on admission | |||
Fever > 3 days, n (%) | 39 (12%) | 554 (77%) | <0.001 |
Dry cough, n (%) | 51 (16%) | 334 (47%) | <0.001 |
Acute dyspnea, n (%) | 90 (28%) | 372 (52%) | <0.002 |
Gastrointestinal symptoms (diarrhea, abdominal discomfort, nausea, vomiting) | 44 (14%) | 107 (15%) | 0.675 |
Fatigue, n (%) | 189 (59%) | 109 (15%) | <0.001 |
Pharyngodynia, n (%) | 16 (5%) | 38 (5%) | 1.000 |
Rhinitis, n (%) | 184 (58%) | 259 (36%) | <0.001 |
Arthralgia/myalgia, n (%) | 16 (5%) | 73 (10%) | 0.007 |
Anosmia, n (%) | 7 (2%) | 31 (4%) | 0.101 |
Conjunctivitis, n (%) | 0 (0%) | 4 (1%) | 0.073 |
Chest pain, n (%) | 18 (6%) | 33 (5%) | 0.508 |
Signs of overload (limb edema and/or pulmonary stasis), n (%) | 37 (12%) | 17 (2%) | <0.001 |
Parenchymal thickening, n (%) | 66 (21%) | 344 (48%) | <0.001 |
Interstitial lung disease, n (%) | 16 (5%) | 31 (4%) | 0.464 |
Pleural effusion, n (%) | 110 (34%) | 191 (27%) | 0.022 |
Cardiomegaly, n (%) | 99 (31%) | 232 (32%) | 0.750 |
Bronchiectasis/emphysema, n (%) | 27 (24%) | 50 (15%) | 0.013 |
Laboratory findings | |||
WBC (×103/µL), median (IQR: 25–75%) | 7.5 (6.4–12.3) | 6.1 (4.5–8.8) | <0.001 |
Neutrophils ×103/µL, median (IQR: 25–75%) | 5.6 (3.8–9.4) | 4.4 (3–7.1) | 0.368 |
Lymphocytes ×103/µL, median (IQR: 25–75%) | 1.1 (0.8–1.8) | 0.9 (0.6–1.2) | <0.001 |
Platelets ×103/µL, median (IQR: 25–75%) | 232 (192–305) | 205 (159–266) | <0.001 |
D-dimer ng/mL, median (IQR: 25–75%) | 820 (367–1322) | 631 (340–1242) | 0.178 |
Serum ferritin ng/mL, median (IQR: 25–75%) | 343 (120–811) | 458 (219–813) | 0.013 |
Procalcitonin ng/mL, median (IQR: 25–75%) | 2.6 (0.4–3) | 0.9 (0.1–1.5) | 0.002 |
LDH mU/mL, mean ± SD | 404 ± 191 | 317 ± 147 | <0.001 |
CPK U/L, median (IQR: 25–75%) | 74 (48–170) | 89 (52–160) | 0.010 |
Lactate mmol/L, mean ± SD | 1.8 ± 1.4 | 1.3 ± 0.8 | <0.001 |
C-reactive protein mg/dL, median (IQR: 25–75%) | 10.3 (6.5–13) | 4 (1.3–9.8) | 0.022 |
Alanine aminotransferase U/L, median (IQR: 25–75%) | 28 (20–46) | 29 (20–42) | 0.258 |
Aspartate aminotransferase U/L, median (IQR: 25–75%) | 26 (18–45) | 22 (16–34) | 0.015 |
PaO2/FiO2, mean ± SD | 326 ± 106 | 317 ± 114 | 0.010 |
Bacterial co-infection, n (%) | 89 (28%) | 144 (20%) | 0.004 |
Days of hospitalization, median (IQR: 25–75%) | 12 (9–19) | 12 (8–19) | 0.376 |
Days to RT-PCR negative test, median (IQR: 25–75%) | - | 14 (11–23) | - |
Variables | Non-COVID-19 n = 319 | COVID-19 n = 717 | p-Value |
---|---|---|---|
Invasive ventilation, n (%) | 27 (8%) | 36 (5%) | 0.059 |
Low oxygen flow or room air, n (%) | 167 (52%) | 480 (67%) | <0.001 |
HFNC/NIV, n (%) | 126 (39%) | 127 (18%) | <0.001 |
30-day mortality, n (%) | 111 (35%) | 61 (9%) | <0.001 |
Variables | OR | CI95% | p-Value |
---|---|---|---|
Fever > 3 days | 14 | 9.06–20.07 | <0.001 |
Dry cough | 4.06 | 3.03–6.05 | <0.001 |
Acute dyspnea | 2.08 | 2.02–3.07 | <0.001 |
Lymphocytes < 1000 × 103/µL | 1.05 | 1.01–2 | 0.027 |
Ferritin > 250 ng/mL | 1.05 | 1.02–1.08 | 0.039 |
Variables | OR | CI95% | p-Value |
---|---|---|---|
Age ≥ 65 years | 4.23 | 2.83–6.33 | <0.001 |
No comorbidities | 0.03 | 0.02–0.04 | <0.001 |
Steroids | 0.16 | 0.1–0.25 | <0.001 |
LMWH | 0.2 | 0.12–0.32 | <0.001 |
Remdesivir | 0.26 | 0.15–0.43 | <0.001 |
ICU admission | 2.51 | 1.44–4.4 | 0.001 |
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Russo, A.; Gentilini Cacciola, E.; Borrazzo, C.; Filippi, V.; Bucci, T.; Vullo, F.; Celani, L.; Binetti, E.; Battistini, L.; Ceccarelli, G.; et al. Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II). Diagnostics 2021, 11, 1368. https://doi.org/10.3390/diagnostics11081368
Russo A, Gentilini Cacciola E, Borrazzo C, Filippi V, Bucci T, Vullo F, Celani L, Binetti E, Battistini L, Ceccarelli G, et al. Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II). Diagnostics. 2021; 11(8):1368. https://doi.org/10.3390/diagnostics11081368
Chicago/Turabian StyleRusso, Alessandro, Elio Gentilini Cacciola, Cristian Borrazzo, Valeria Filippi, Tommaso Bucci, Francesco Vullo, Luigi Celani, Erica Binetti, Luigi Battistini, Giancarlo Ceccarelli, and et al. 2021. "Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II)" Diagnostics 11, no. 8: 1368. https://doi.org/10.3390/diagnostics11081368