Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: A retrospective cohort study of patients with and without COVID-19
Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: A retrospective cohort study of patients with and without COVID-19
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DOI：
10.1016/j.eclinm.2020.100518
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发表时间：
2020-10-01
影响因子：
15.1
通讯作者：
Langelier, Charles
中科院分区：
文献类型：
--
作者：
Shah, Sachin J.;Barish, Peter N.;Langelier, Charles
背景：关于 COVID-19 患者的临床表现、诊断和结果的大多数数据均以病例系列的形式提供，未与其他急性呼吸道疾病患者进行比较。方法：我们对 2020 年 2 月 3 日至 3 月 31 日期间患有急性呼吸道疾病的急诊科患者进行了检查，这些患者接受了 SARS-CoV-2 检测。我们通过 PCR 和宏基因组下一代测序 (mNGS) 确定了 COVID-19 状态。我们比较了临床表现、诊断、治疗和结果。结果：在 316 名患者中，33 名 SARS-CoV-2 检测呈阳性； 31 名未患 COVID-19 的人检测出另一种呼吸道病毒呈阳性。在接受额外病毒检测的患者中 (27/33)，未发现 SARS-CoV-2 合并感染。与检测结果呈阴性的患者相比，COVID-19 患者报告的症状持续时间更长（中位 7 天与 3 天，p < 0.001）。 COVID-19 患者住院的比例更高（79% vs. 56%，p = 0.014）。住院时，COVID-19 患者的住院时间较长（中位时间 10.7 天 vs. 4.7 天，p < 0.001），并且更常发生 ARDS（23% vs. 3%，p < 0.001）。大多数合并症、药物、症状、生命体征、实验室、治疗和结果并不因 COVID-19 状态而异。解释：虽然我们发现与其他急性呼吸道疾病相比，COVID-19 的临床特征存在差异，但在表现和合并症方面存在显着重叠。 COVID-19 患者更有可能入院、住院时间更长并出现 ARDS，并且不太可能同时存在病毒感染。 (C) 2020 作者。由爱思唯尔有限公司出版
Background: Most data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have been presented as case series without comparison to patients with other acute respiratory illnesses.Methods: We examined emergency department patients between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared clinical presentation, diagnostics, treatment, and outcomes.Findings: Among 316 patients, 33 tested positive for SARS-CoV-2; 31 without COVID-19 tested positive for another respiratory virus. Among patients with additional viral testing (27/33), no SARS-CoV-2 co-infections were identified. Compared to those who tested negative, patients with COVID-19 reported longer symptoms duration (median 7d vs. 3d, p < 0.001). Patients with COVID-19 were more often hospitalized (79% vs. 56%, p = 0.014). When hospitalized, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p < 0.001) and more often developed ARDS (23% vs. 3%, p < 0.001). Most comorbidities, medications, symptoms, vital signs, laboratories, treatments, and outcomes did not differ by COVID-19 status.Interpretation: While we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections. (C) 2020 The Author(s). Published by Elsevier Ltd.