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Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: a comparison of patients with and without SARS-CoV-2 infection

Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: a comparison of patients with and without SARS-CoV-2 infection
Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: a comparison of patients with and without SARS-CoV-2 infection
Objectives Most reports describing the characteristics of patients hospitalised with COVID-19 lack a comparator group. We compared clinical characteristics, symptoms, and outcomes of adults presenting to hospital during the pandemic first wave, who tested positive and negative for SARS-CoV-2. Methods Detailed patient data was obtained from a large, controlled, non-randomised trial of molecular point-of-care testing versus laboratory RT-PCR for SARS-CoV-2 in adults presenting to a large UK hospital with suspected COVID-19. Results 1054 patients were included: 352 (33.4%) tested positive and 702 (66.6%) negative. 13.4% (47/352) COVID-19-positive patients had COPD versus 18.7% (131/702) of COVID-19-negative patients (difference=5.3% [95%CI -9.7% to -0.5%], p=0.0297). 5.7% (20/352) of COVID-19-positive patients were smokers versus 16.5% (116/702) of negative patients (difference=-10.8% [-14.4% to -7.0%], p=0.0001). 70.5% (248/352) of COVID-19-positive patients were White-British versus 85.5% (600/702) of negative patients (difference=-15.0% [-20.5% to -9.7%], p<0.0001). 20.9% (39/187) of COVID-19-positive patients were healthcare workers versus 5.2% (15/287) of negative patients (p<0.0001). Anosmia was reported in 33.1% (47/142) versus 8.8% (19/216) of COVID-19-positive and negative patients respectively (p<0.0001). Non-SARS-CoV-2 respiratory viruses or atypical bacteria were detected in 2.5% (5/197) of COVID-19 patients versus 7.9% (24/302) of COVID-19-negative patients (p=0.0109). Hospitalisation duration and 30-day-mortality were higher in COVID-19 patients and invasive ventilation was more frequent (11.1% vs 2.8%, p<0.0001), and longer (14.5 vs 4.7 days, p=0.0015). Conclusions There were substantial differences between patients with and without COVID-19 in terms of ethnicity, healthcare worker-status, comorbidities, symptoms, and outcomes. These data can inform healthcare planning for the next phase of the pandemic.
COPD, COVID-19, Clinical characteristics, Cohort, Healthcare workers, Outcomes, SARS-CoV-2, Smokers, Symptoms
0163-4453
937
Brendish, Nathan
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Poole, Stephen
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Naidu, Vasanth
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Mansbridge, Christopher
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Norton, Nicholas
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Borca, Florina
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Phan, Hang Thi Thu
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Wheeler, Helen
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Harvey, Matthew
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Presland, Laura
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Clark, Tristan
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Brendish, Nathan
a8a4189e-01eb-4ab3-933e-a24cd188a4d7
Poole, Stephen
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Naidu, Vasanth
df9bd215-344a-43b6-b568-60c783353fa9
Mansbridge, Christopher
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Norton, Nicholas
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Borca, Florina
31fc3965-6bcf-4fd6-85bc-8b0f99f62473
Phan, Hang Thi Thu
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Wheeler, Helen
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Harvey, Matthew
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Presland, Laura
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Clark, Tristan
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Brendish, Nathan, Poole, Stephen, Naidu, Vasanth, Mansbridge, Christopher, Norton, Nicholas, Borca, Florina, Phan, Hang Thi Thu, Wheeler, Helen, Harvey, Matthew, Presland, Laura and Clark, Tristan (2020) Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: a comparison of patients with and without SARS-CoV-2 infection. Journal of Infection, 81 (6), 937. (doi:10.1016/j.jinf.2020.09.033).

Record type: Article

Abstract

Objectives Most reports describing the characteristics of patients hospitalised with COVID-19 lack a comparator group. We compared clinical characteristics, symptoms, and outcomes of adults presenting to hospital during the pandemic first wave, who tested positive and negative for SARS-CoV-2. Methods Detailed patient data was obtained from a large, controlled, non-randomised trial of molecular point-of-care testing versus laboratory RT-PCR for SARS-CoV-2 in adults presenting to a large UK hospital with suspected COVID-19. Results 1054 patients were included: 352 (33.4%) tested positive and 702 (66.6%) negative. 13.4% (47/352) COVID-19-positive patients had COPD versus 18.7% (131/702) of COVID-19-negative patients (difference=5.3% [95%CI -9.7% to -0.5%], p=0.0297). 5.7% (20/352) of COVID-19-positive patients were smokers versus 16.5% (116/702) of negative patients (difference=-10.8% [-14.4% to -7.0%], p=0.0001). 70.5% (248/352) of COVID-19-positive patients were White-British versus 85.5% (600/702) of negative patients (difference=-15.0% [-20.5% to -9.7%], p<0.0001). 20.9% (39/187) of COVID-19-positive patients were healthcare workers versus 5.2% (15/287) of negative patients (p<0.0001). Anosmia was reported in 33.1% (47/142) versus 8.8% (19/216) of COVID-19-positive and negative patients respectively (p<0.0001). Non-SARS-CoV-2 respiratory viruses or atypical bacteria were detected in 2.5% (5/197) of COVID-19 patients versus 7.9% (24/302) of COVID-19-negative patients (p=0.0109). Hospitalisation duration and 30-day-mortality were higher in COVID-19 patients and invasive ventilation was more frequent (11.1% vs 2.8%, p<0.0001), and longer (14.5 vs 4.7 days, p=0.0015). Conclusions There were substantial differences between patients with and without COVID-19 in terms of ethnicity, healthcare worker-status, comorbidities, symptoms, and outcomes. These data can inform healthcare planning for the next phase of the pandemic.

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Accepted/In Press date: 25 September 2020
e-pub ahead of print date: 28 September 2020
Keywords: COPD, COVID-19, Clinical characteristics, Cohort, Healthcare workers, Outcomes, SARS-CoV-2, Smokers, Symptoms

Identifiers

Local EPrints ID: 444193
URI: http://eprints.soton.ac.uk/id/eprint/444193
ISSN: 0163-4453
PURE UUID: 0c4fd2cf-f2f9-4c82-8863-7f6ce7fea4eb
ORCID for Nathan Brendish: ORCID iD orcid.org/0000-0002-9589-4937
ORCID for Tristan Clark: ORCID iD orcid.org/0000-0001-6026-5295

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Date deposited: 01 Oct 2020 16:31
Last modified: 07 Oct 2021 04:03

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