Clinical Characteristics and Factors Associated with Disease Progression of Mild to Moderate COVID-19 Patients in a Makeshift (Fangcang) Hospital: A Retrospective Cohort Study
Abstract:Objective
Information regarding the epidemiology and clinical features of mild to moderate patients caused by COVID-19 in Fangcang Hospital is scarce. Through a retrospective cohort study, the clinical characteristics of COVID-19 patients in Dongxihu Fangcang shelter hospitals were analyzed, and the factors that affected the disease progression of COVID-19 patients were explored.
Methods
The clinical characteristics of 714 patients with COVID-19 were retrospectively ana… Show more
“…However, there are still some COVID-19 patients who under risk to severe or even critical condition. Our results showed that 39(0.15%) of 25207 patients were deteriorated and transferred to the designated hospital, which was much less than transfer rate of Fangcang hospitals reported in other COVID-19 waves ( Wang et al., 2020 ; Venturini et al., 2021 ; Liu et al., 2021 ). This result indicated that COVID-19 patients of the omicron variant infection presented a lessened clinical severity and degraded virulence in comparison of the wild-type strain or other VOCs.…”
Section: Discussioncontrasting
confidence: 67%
“…Some studies on large sample of Fangcang hospital cases showed that the most common symptom of COVID-19 was fever ( Wang et al., 2020 ; Lv and Lv, 2021 ; Liu et al., 2021 ). In our study of 25,207 patients, cough (44.5%) and expectoration (38.4%) were the most two common symptoms.…”
Section: Discussionmentioning
confidence: 99%
“…The first case in China was identified on December 9, 2021 ( De Vito et al., 2021 ). BA.1 and BA.2 are major Omicron variant sub-lineages in local COVID-19 outbreaks of China ( Chen et al., 2020 ; Liu et al., 2021 ; Nishiura et al., 2021 ). Studies showed that the omicron variant caused a milder viremia than the previous VOCs, which presented as reduced hospital stays and decreased severity and mortality rate ( Soy et al., 2020 ; Ye et al., 2020 ; Ito et al., 2022 ).…”
ObjectivesTo summarize the clinical characteristics of patients infected by SARS-CoV-2 omicron variant and explore the risk factors affecting the progression in a Fangcang hospital, Shanghai, China.MethodsA total of 25,207 patients were retrospectively enrolled. We described the clinical characteristics and performed univariate and multivariate logistic regression analysis to identify the risk factors for non-severe to severe COVID-19 or death.ResultsAccording to the outcomes, there were 39 severe patients (including 1 death) and 25,168 non-severe patients enrolled in this study. Among the 25,207 cases, the median age was 45 years (IQR 33-54), and 65% patients were male. Cough (44.5%) and expectoration (38.4%) were the most two common symptoms. Hypertension (10.4%) and diabetes (3.5%) were most two common comorbidities. Most patients (81.1%) were fully vaccinated. The unvaccinated and partially vaccinated patients were 15.1% and 3.9%, respectively. The length of viral shedding time was six days (IQR 4-9) in non-severe patients. Multivariate logistic regression analysis suggested that age (OR=1.062, 95%CI 1.034-1.090, p<0.001), fever (OR=2.603, 95%CI 1.061-6.384, p=0.037), cough (OR=0.276, 95%CI 0.119-0.637, p=0.003), fatigue (OR=4.677, 95%CI 1.976-11.068, p<0.001), taste disorders (OR=14.917, 95%CI 1.884-118.095, p=0.010), and comorbidity (OR=2.134, 95%CI 1.059-4.302, p=0.034) were predictive factors for deterioration of SARS-CoV-2 omicron variant infection.ConclusionsNon-critical patients have different clinical characteristics from critical patients. Age, fever, cough, fatigue, taste disorders, and comorbidity are predictors for the deterioration of SARS-CoV-2 omicron variant infection.
“…However, there are still some COVID-19 patients who under risk to severe or even critical condition. Our results showed that 39(0.15%) of 25207 patients were deteriorated and transferred to the designated hospital, which was much less than transfer rate of Fangcang hospitals reported in other COVID-19 waves ( Wang et al., 2020 ; Venturini et al., 2021 ; Liu et al., 2021 ). This result indicated that COVID-19 patients of the omicron variant infection presented a lessened clinical severity and degraded virulence in comparison of the wild-type strain or other VOCs.…”
Section: Discussioncontrasting
confidence: 67%
“…Some studies on large sample of Fangcang hospital cases showed that the most common symptom of COVID-19 was fever ( Wang et al., 2020 ; Lv and Lv, 2021 ; Liu et al., 2021 ). In our study of 25,207 patients, cough (44.5%) and expectoration (38.4%) were the most two common symptoms.…”
Section: Discussionmentioning
confidence: 99%
“…The first case in China was identified on December 9, 2021 ( De Vito et al., 2021 ). BA.1 and BA.2 are major Omicron variant sub-lineages in local COVID-19 outbreaks of China ( Chen et al., 2020 ; Liu et al., 2021 ; Nishiura et al., 2021 ). Studies showed that the omicron variant caused a milder viremia than the previous VOCs, which presented as reduced hospital stays and decreased severity and mortality rate ( Soy et al., 2020 ; Ye et al., 2020 ; Ito et al., 2022 ).…”
ObjectivesTo summarize the clinical characteristics of patients infected by SARS-CoV-2 omicron variant and explore the risk factors affecting the progression in a Fangcang hospital, Shanghai, China.MethodsA total of 25,207 patients were retrospectively enrolled. We described the clinical characteristics and performed univariate and multivariate logistic regression analysis to identify the risk factors for non-severe to severe COVID-19 or death.ResultsAccording to the outcomes, there were 39 severe patients (including 1 death) and 25,168 non-severe patients enrolled in this study. Among the 25,207 cases, the median age was 45 years (IQR 33-54), and 65% patients were male. Cough (44.5%) and expectoration (38.4%) were the most two common symptoms. Hypertension (10.4%) and diabetes (3.5%) were most two common comorbidities. Most patients (81.1%) were fully vaccinated. The unvaccinated and partially vaccinated patients were 15.1% and 3.9%, respectively. The length of viral shedding time was six days (IQR 4-9) in non-severe patients. Multivariate logistic regression analysis suggested that age (OR=1.062, 95%CI 1.034-1.090, p<0.001), fever (OR=2.603, 95%CI 1.061-6.384, p=0.037), cough (OR=0.276, 95%CI 0.119-0.637, p=0.003), fatigue (OR=4.677, 95%CI 1.976-11.068, p<0.001), taste disorders (OR=14.917, 95%CI 1.884-118.095, p=0.010), and comorbidity (OR=2.134, 95%CI 1.059-4.302, p=0.034) were predictive factors for deterioration of SARS-CoV-2 omicron variant infection.ConclusionsNon-critical patients have different clinical characteristics from critical patients. Age, fever, cough, fatigue, taste disorders, and comorbidity are predictors for the deterioration of SARS-CoV-2 omicron variant infection.
“…The data from this cohort showed an average length of hospital stay of 7.18 ± 3.05 days, as compared to the 16.08 ± 5.13 days for those who were treated at Fangcang shelter hospitals during the outbreak of the original alpha strain in Wuhan, in early March, 2020. 4 Additional analysis of the cumulative discharge incidence revealed that about 50% of patients were discharged on day 6 and 90% were discharged on day 10 ( Figure A ), indicating a much faster hospital bed turnover rate and a generally milder spectrum of symptoms for this wave of Omicron infection compared to that of alpha strain infection in Wuhan. 4 The data is further supported by a recent study in Southern California by Lewnard et al, that symptomatic hospital admission due to Delta variant is roughly 2.5 times more than that of Omicron infection.…”
mentioning
confidence: 96%
“… 4 Additional analysis of the cumulative discharge incidence revealed that about 50% of patients were discharged on day 6 and 90% were discharged on day 10 ( Figure A ), indicating a much faster hospital bed turnover rate and a generally milder spectrum of symptoms for this wave of Omicron infection compared to that of alpha strain infection in Wuhan. 4 The data is further supported by a recent study in Southern California by Lewnard et al, that symptomatic hospital admission due to Delta variant is roughly 2.5 times more than that of Omicron infection. 5 Figure A A.…”
Coronavirus outbreak was a public health emergency. The surge of new confirmed cases and deaths was observed in developing countries due to the occurrence of new variants. However, factors associated with the duration of recovery among admitted patients remained uncertain. Therefore, we assessed factors associated with time to recovery from Covid-19 among hospitalized patients at the treatment center in South Central, Ethiopia. We employed a retrospective cross-sectional study among 422 patients hospitalized at Bokoji Hospital treatment center with Covid-19 from July 1, 2020, through October 30, 2021. Data were entered, coded, and analyzed using SPSS 26 version. We computed the survival probability using the Kaplan Meier method and determined factors associated with time to recovery using Cox regression analysis. Finally, the interpretation of adjusted hazard ratio (AHR) with 95% Confidence Interval (CI) and P-values less than 0.05 were declared as statistically significant. Our study found that the median time to recovery from Covid-19 infection of 13 days, with an IQR of 9–17 days. In multivariate Cox regression, ≥ 60 years old (AHR = 0.66; 95% CI: 0.49, 0.895), chronic pulmonary disease (AHR = 0.67; 95% CI: 0.455, 0.978), Male (AHR = 0.77; 95% CI: 0.611, 0.979), and being on Intranasal oxygen care (AHR = 0.56; 95% CI: 0.427–0.717) were significantly associated with time to recovery. Thus, health providers in treatment centers should give strict follow-up and priority for elders, patients with underlying diseases, and under supportive treatment during case management.
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