Characteristics of Adult Outpatients and Inpatients with COVID-19 — 11 Academic Medical Centers, United States, March–May 2020

Tenforde, Mark W; Rose, Erica Billig; Lindsell, Christopher J.; Shapiro, Nathan I.; Files, D. Clark; Gibbs, Kevin W.; Prekker, Matthew E.; Steingrub, Jay S.; Smithline, Howard; Gong, Michelle N.; Aboodi, Michael S.; Exline, Matthew C.; Henning, Daniel J.; Wilson, Jennifer G.; Khan, Akram; Qadir, Nida; Stubblefield, William B; Patel, Manish; Self, Wesley H.; Feldstein, Leora R.

doi:10.15585/mmwr.mm6926e3

Cited by 204 publications

(217 citation statements)

References 7 publications

(7 reference statements)

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“…In our study, a slightly higher percentage (12.2%) of the patients were tested and only one patient (0.6%) reported being hospitalized for the infection. While in a recent report of 350 patients in the USA who tested positive for the infection [20] the median number of symptoms out of 17 was 7 (range 4-10), in our sample, the median number of symptoms out of 15 was 2.0 (range 0 to 15). However, for four of the fifteen COVID-19 symptoms evaluated (i.e., persistent fever, repeated shaking chills, severe chest pain, ringing in your ears), patients not on active treatment reported higher occurrence rates.…”

Section: Discussioncontrasting

confidence: 78%

Oncology patients’ perceptions of and experiences with COVID-19

Miaskowski

Paul

Snowberg

et al. 2020

Support Care Cancer

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Purpose No information is available on cancer patients' knowledge of and experiences with COVID-19. We undertook an evaluation of differences in COVID-19 symptom occurrence rates, COVID-19 testing rates, clinical care activities, knowledge of COVID-19, and use of mitigation procedures between patients who were and were not receiving active cancer treatment. Methods Patients enrolled were > 18 years of age; had a diagnosis of cancer; and were able to complete the emailed study survey online. Results Of the 174 patients who participated, 27.6% (n = 48) were receiving active treatment, 13.6% were unemployed because of COVID-19, 12.2% had been tested for COVID-19, and 0.6% had been hospitalized for COVID-19. Patients who were not on active treatment reported a higher mean number of COVID-19 symptoms (3.1 (± 4.2) versus 1.9 (± 2.6)), and patients who reported a higher number of COVID-19 symptoms were more likely to be tested. Over 55% of the patients were confident that their primary care provider could diagnose COVID-19, and the majority of the patients had high levels of adherence with the use of precautionary measures (e.g., social distancing, use of face coverings). Conclusion The high level of COVID-19 symptoms and the significant overlap of COVID-19 and cancer-related symptoms pose challenges for clinicians who are assessing and triaging oncology patients for COVID-19 testing. For patients on active treatment, clinicians face challenges with how to assess and manage symptoms that, prior to COVID-19, would be ascribed to acute toxicities associated with cancer treatments or persistent symptoms in cancer survivors.

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Section: Discussioncontrasting

confidence: 78%

Oncology patients’ perceptions of and experiences with COVID-19

Miaskowski

Paul

Snowberg

et al. 2020

Support Care Cancer

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“…8 Subsequently, similar findings have been reported from Europe, the Middle East, and the US. [9][10][11][12] Although there are emerging data regarding timing of viral clearance and immunologic response in adults with COVID-19, 13 there are few data in the pediatric population. Furthermore, knowledge of factors affecting time-to-seropositivity is lacking in both pediatric and adult patients.…”

Section: Original Articlesmentioning

confidence: 99%

Kinetics of Viral Clearance and Antibody Production Across Age Groups in Children with Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Bahar

Jacquot

et al. 2020

The Journal of Pediatrics

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Objectives To improve understanding of transition from viral infection to viral clearance, and antibody response in pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Study design This retrospective analysis of children tested for SARS-CoV-2 by reverse transcription (RT) polymerase chain reaction (PCR) and immunoglobulin G antibody at a quaternary-care, free-standing pediatric hospital between March 13, 2020, and June 21, 2020, included 6369 patients who underwent PCR testing and 215 patients who underwent antibody testing. During the initial study period, testing focused primarily on symptomatic children; the later study period included asymptomatic patients who underwent testing as preadmission or preprocedural screening. We report the proportion of positive and negative tests, time to viral clearance, and time to seropositivity. Results The rate of positivity varied over time due to viral circulation in the community and transition from targeted testing of symptomatic patients to more universal screening of hospitalized patients. Median duration of viral shedding (RT-PCR positivity) was 19.5 days and time from RT-PCR positivity to negativity was 25 days. Of note, patients aged 6 through 15 years demonstrated a longer time of RT-PCR positivity to negativity, compared with patients aged 16 through 22 years (median 32 vs 18 days, P = .015). Median time to seropositivity, by chemiluminescent testing, from RT-PCR positivity was 18 days, whereas median time to reach adequate levels of neutralizing antibodies (defined as comparable with 160 titer by plaque reduction neutralization testing) was 36 days. Conclusions The majority of patients demonstrated a prolonged period of viral shedding after infection with SARS CoV-2. It is unknown whether this correlates with persistent infectivity. Only 17 of 33 patients demonstrated adequate neutralizing antibodies during the time frame of specimen collection. It remains unknown whether immunoglobulin G antibody against spike structured proteins correlates with immunity, and how long antibodies and potential protection persist.

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“…The pandemic of SARS-CoV-2 infection causing coronavirus disease-2019 (COVID-19, hereafter "COVID") has affected almost every country globally [1]. Understanding the sociodemographic characteristics of COVID patients can inform efforts to reduce transmission [2]. In Canada and other high-income country settings where reliable data can be gathered, a combination of population-based surveys (including surveys and testing), hospitalizations, and mortality data can produce an accurate profile of the impact of the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Predictors of self-reported symptoms and testing for COVID-19 in Canada using a nationally representative survey

Jha

Lam³

et al. 2020

PLoS ONE

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Random population-based surveys to estimate prevalence of SARS-CoV2 infection causing coronavirus disease (COVID-19) are useful to understand distributions and predictors of the infection. In April 2020, the first-ever nationally representative survey in Canada polled 4,240 adults age 18 years and older about self-reported COVID experience in March, early in the epidemic. We examined the levels and predictors of COVID symptoms, defined as fever plus difficulty breathing/shortness of breath, dry cough so severe that it disrupts sleep, and/or loss of sense of smell; and testing for SARS-CoV-2 by respondents and/or household members. About 8% of Canadians reported that they and/or one or more household members experienced COVID symptoms. Symptoms were more common in younger than in older adults, and among visible minorities. Overall, only 3% of respondents and/or household members reported testing for SARS-CoV-2. Being tested was associated with having COVID symptoms, Indigenous identity, and living in Quebec. Periodic nationally representative surveys of symptoms, as well as SARS-CoV-2 antibodies, are required in many countries to understand the pandemic and prepare for the future.

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Characteristics of Adult Outpatients and Inpatients with COVID-19 — 11 Academic Medical Centers, United States, March–May 2020

Abstract: ; CDC COVID-19 Response Team * Patients with a proxy respondent were more likely to have been hospitalized (83% versus 23%) and to be older (median age = 67 versus 43 years) than were patients who responded for themselves.

Cited by 204 publications

References 7 publications

Oncology patients’ perceptions of and experiences with COVID-19

Oncology patients’ perceptions of and experiences with COVID-19

Kinetics of Viral Clearance and Antibody Production Across Age Groups in Children with Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Predictors of self-reported symptoms and testing for COVID-19 in Canada using a nationally representative survey

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