Background After mild COVID-19, some outpatients experience persistent symptoms. However, data are scarce and prospective studies are urgently needed. Objectives To characterize the post-COVID-19 syndrome after mild COVID-19 and identify predictors. Participants Outpatients with symptoms suggestive of COVID-19 with (1) PCR-confirmed COVID-19 (COVID-positive) or (2) SARS-CoV-2 negative PCR (COVID-negative). Design Monocentric cohort study with prospective phone interview between more than 3 months to 10 months after initial visit to the emergency department and outpatient clinics. Main Measures Data of the initial visits were extracted from the electronic medical file. Predefined persistent symptoms were assessed through a structured phone interview. Associations between long-term symptoms and PCR results, as well as predictors of persistent symptoms among COVID-positive, were evaluated by multivariate logistic regression adjusted for age, gender, smoking, comorbidities, and timing of the survey. Key Results The study population consisted of 418 COVID-positive and 89 COVID-negative patients, mostly young adults (median age of 41 versus 36 years in COVID-positive and COVID-negative, respectively; p = 0.020) and healthcare workers (67% versus 82%; p = 0.006). Median time between the initial visit and the phone survey was 150 days in COVID-positive and 242 days in COVID-negative patients. Persistent symptoms were reported by 223 (53%) COVID-positive and 33 (37%) COVID-negative patients ( p = 0.006) and proportions were stable among the periods of the phone interviews. Overall, 21% COVID-positive and 15% COVID-negative patients ( p = 0.182) attended care for this purpose. Four surveyed symptoms were independently associated with COVID-19: fatigue (adjusted odds ratio 2.14, 95% CI 1.04–4.41), smell/taste disorder (26.5, 3.46–202), dyspnea (2.81, 1.10–7.16), and memory impairment (5.71, 1.53–21.3). Among COVID-positive, female gender (1.67, 1.09–2.56) and overweight/obesity (1.67, 1.10–2.56) were predictors of persistent symptoms. Conclusions More than half of COVID-positive outpatients report persistent symptoms up to 10 months after a mild disease. Only 4 of 14 symptoms were associated with COVID-19 status. The symptoms and predictors of the post-COVID-19 syndrome need further characterization as this condition places a significant burden on society. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07242-1.
Background Coronavirus disease 2019 (COVID-19) is now a global pandemic with Europe and the USA at its epicenter. Little is known about risk factors for progression to severe disease in Europe. This study aims to describe the epidemiology of COVID-19 patients in a Swiss university hospital. Methods This retrospective observational study included all adult patients hospitalized with a laboratory confirmed SARS-CoV-2 infection from March 1 to March 25, 2020. We extracted data from electronic health records. The primary outcome was the need to mechanical ventilation at day 14. We used multivariate logistic regression to identify risk factors for mechanical ventilation. Follow-up was of at least 14 days. Results 200 patients were included, of whom 37 (18.5%) needed mechanical ventilation at 14 days. The median time from symptoms onset to mechanical ventilation was 9.5 days (IQR 7.00, 12.75). Multivariable regression showed increased odds of mechanical ventilation in males (3.26, 1.21-9.8; p=0.025), in patients who presented with a qSOFA score ≥2 (6.02, 2.09-18.82; p=0.001), with bilateral infiltrate (5.75, 1.91-21.06; p=0.004) or with a CRP of 40 mg/l or greater (4.73, 1.51-18.58; p=0.013). Conclusions This study gives some insight in the epidemiology and clinical course of patients admitted in a European tertiary hospital with SARS-CoV-2 infection. Male sex, high qSOFA score, CRP of 40 mg/l or greater and a bilateral radiological infiltrate could help clinicians identify patients at high risk for mechanical ventilation.
Background Some patients experience long-term symptoms after COVID-19, but data on outpatients with mild-to-moderate COVID-19 are scarce. Objective To describe persisting symptoms more than 3 months after infection in PCR-confirmed COVID-19 in comparison to negative SARS-CoV-2 PCR outpatients and to identify predictors of long-term symptoms in COVID-19. Setting Outpatient clinics of a Swiss university center. Patients 418 symptomatic outpatients with PCR-confirmed COVID-19 (COVID-positive) and 89 negative SARS-CoV-2 PCR (COVID-negative). Design Prospective cohort study. Measurements Predefined long-term symptoms were evaluated though a phone interview >3 to 10 months after diagnosis. Associations between long-term symptoms and PCR test result, as well predictors of persisting symptoms in COVID-positive were evaluated by multivariate logistic regression including potential confounders (age, sex, smoking, comorbidities, time of the phone survey). Results The study population consisted mostly of young (median of 41 versus 36 years in COVID-positive and COVID-negative, respectively; p=0.020) health care workers (67% versus 82%; p=0.006).. Persisting symptoms were reported by 223 (53%) COVID-positive and 33 (37%) COVID-negative (p=0.006). Overall, 21% COVID-positive and 15% COVID-negative (p=0.182) consulted a doctor for these symptoms. Four surveyed symptoms were independently associated with COVID-19: fatigue (adjusted odds ratio [aOR] 2.14, 95%CI 1.04-4.41), smell/taste disorder (26.5, 3.46-202), dyspnea (2.81, 1.10-7.16) and memory impairment (5.71, 1.53-21.3). Among COVID-positive, female gender (aOR 1.67, 95% CI 1.09-2.56) and overweight/obesity (1.67, 1.10-2.56) were predictors of persisting symptoms. Limitations Undiagnosed SARS-CoV-2 infection in COVID-negative cannot be completely excluded. Conclusion More than half of COVID-positive outpatients report persisting symptoms up to 10 months after infection and 21% seek medical care for this reason. These data suggest that post-COVID syndrome places a significant burden on society and especially healthcare systems.
The study shows that even though the performance of Vitek 2 Advanced Expert System was good in identifying enterococci to species level, it is important to verify results by a molecular method when phenotypic findings are discordant with epidemiologic patterns. Furthermore, GeneXpert(®) vanA/vanB PCR and ChromID VRE combined with in-house PCR were applied in rectal samples for the detection of VRE colonization among critically ill patients. GeneXpert(®) showed an excellent performance in detecting vanA-positive enterococci, but false-positive results for vanB-gene detection render its application problematic in departments with high incidence of vanB-positive enterococci.
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