Association between COVID-19 prognosis and disease presentation, comorbidities and chronic treatment of hospitalized patients

Abstract

Importance The rapid pandemic expansion of the disease caused by the new SARS-CoV-2 virus has compromised health systems worldwide. Knowledge of prognostic factors in affected patients can help optimize care. Objective The objective of this study was to analyze the relationship between the prognosis of COVID-19 and the form of presentation of the disease, the previous pathologies of patients and their chronic treatments. Design, participants and locations This was an observational study on a cohort of 418 patients admitted to three regional hospitals in Catalonia (Spain). As primary outcomes, severe disease (need for oxygen therapy via nonrebreather mask or mechanical ventilation) and death were studied. Multivariate binary logistic regression models were performed to study the association between the different factors and the results. Results Advanced age, male sex and obesity were independent markers of poor prognosis. The most frequent presenting symptom was fever, while dyspnea was associated with severe disease and the presence of cough with greater survival. Low oxygen saturation in the emergency room, elevated CRP in the emergency room and initial radiological involvement were all related to worse prognosis. The presence of eosinophilia (% of eosinophils) was an independent marker of less severe disease. Conclusions This study identified the most robust markers of poor prognosis for COVID-19. These results can help to correctly stratify patients at the beginning of hospitalization based on the risk of developing severe disease.

Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation

“…Individuals at highest risk of severe disease and deaths were patients with age > 80 years and associated co-morbidities such as underlying cardiovascular disease, diabetes, hypertension, chronic respiratory disease, and cancer ( 1 ). Another study done with 418 patients in Catalonia (Spain) showed that dyspnea was an important predictor of severe disease while confusion was an important predictor of death, and the presence of cough was strongly associated with good prognosis ( 84 ). Advanced age, male sex, and obesity were independent markers of poor prognosis while eosinophilia was a marker of less severe disease ( 84 ).…”

“…Another study done with 418 patients in Catalonia (Spain) showed that dyspnea was an important predictor of severe disease while confusion was an important predictor of death, and the presence of cough was strongly associated with good prognosis ( 84 ). Advanced age, male sex, and obesity were independent markers of poor prognosis while eosinophilia was a marker of less severe disease ( 84 ). The mortality was lower in patients with symptoms of diarrhea, arthromyalgia, headache, and loss of smell and taste sensations while low oxygen saturation, high CRP levels, and higher number of lung quadrants affected on Xray were found to be associated with severe disease and death ( 84 ).…”

Meta-Analysis of Atrial Fibrillation in Patients With COVID-19

“…Nine hundred and sixteen potentially relevant studies were screened according to the inclusion and exclusion criteria. Finally, 23 studies with 108,745 COVID-19 patients 1 , 2 , 3 , 4 , 5 , 6 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 were eligibly included in the present quantitative meta-analysis. The study characteristics are summarized in Table 1 .…”

COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-old Population. A Cohort Study.

“…Although the most frequent symptoms were the same as in the hospitalized adult population [12,15,16], they were less frequent than has been reported in this population (especially cough), even though the diagnosis of respiratory infection was an inclusion criterion in our study. On the other hand, confusion stands out as a symptom present in 11% of our sample.…”