Clinical characteristics of coronavirus disease (COVID-19) early findings from a teaching hospital in Pavia, North Italy, 21 to 28 February 2020

Colaneri, Marta; Sacchi, Paolo; Zuccaro, Valentina; Biscarini, Simona; Sachs, Michele; Roda, Silvia; Pieri, Teresa Chiara; Valsecchi, Pietro; Piralla, Antonio; Seminari, Elena; Matteo, Angela Di; Novati, Stefano; Maiocchi, Laura; Pagnucco, Layla; Tirani, Marcello; Baldanti, Fausto; Mojoli, Francesco; Perlini, Stefano; Bruno, Raffaele

doi:10.2807/1560-7917.es.2020.25.16.2000460

Cited by 134 publications

(137 citation statements)

References 20 publications

(23 reference statements)

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“…The clinical features of cough, fever, myalgia, headache as well as a constellation of other respiratory and nonrespiratory features reflect the description of COVID-19 reported in the literature [6,7]. Although 46/100 (46%) of patients had more than one symptom, only 2/100 (2%) had all 3 classic features of COVID-19, i.e.…”

Section: Discussionsupporting

confidence: 77%

Partial compliance with symptom-based testing pathways reveals asymptomatic carriage of SARS-CoV-2 in Ireland

et al. 2020

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Section: Discussionsupporting

confidence: 77%

Partial compliance with symptom-based testing pathways reveals asymptomatic carriage of SARS-CoV-2 in Ireland

et al. 2020

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“…The clinical characteristics and clinical course of COVID-19 patients hospitalised in Lyon were similar to those reported in California [6], New York City [9], and Italy [5,7,8], which supports the generalisability of the proposed prediction tool. As reported in the analysis published byWynants et al [10], the most frequently reported diagnostic and prognostic predictors of covid-19 are age, body temperature, lymphocyte count and lung imaging characteristics.…”

Section: Discussionsupporting

confidence: 75%

“…The most frequently reported diagnostic and prognostic predictors of COVID-19 are age, body temperature, lymphocyte count, and lung imaging characteristics. Flu-like symptoms and neutrophil counts are frequently predictive in diagnostic models, while co-morbidities, sex, C-reactive protein and creatinine are frequent prognostic factors [4][5][6][7][8][9][10]. With more than 90% of deaths occurring in patients over the age of 60 years, and a predominance of males, French data are consistent with that reported worldwide [1, [4][5][6][7][8][9].…”

Section: Introductionsupporting

confidence: 67%

“…Flu-like symptoms and neutrophil counts are frequently predictive in diagnostic models, while co-morbidities, sex, C-reactive protein and creatinine are frequent prognostic factors [4][5][6][7][8][9][10]. With more than 90% of deaths occurring in patients over the age of 60 years, and a predominance of males, French data are consistent with that reported worldwide [1, [4][5][6][7][8][9]. In Italy [11], a higher case-fatality rate (7.2%) compared to China (2.3%) was attributed to a higher proportion of elderly people [12], obviously if the methods for classifying and reporting deaths due to COVID-19 disease were the same.…”

Section: Introductionmentioning

confidence: 99%

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Predicting an Unfavourable Course in Patients Hospitalised for COVID-19: The PREDICT-COVID Study

Ducher

Elias

Florens

et al. 2020

Preprint

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Background. Clinical decision tools that have been proposed to predict the clinical course of patients admitted to hospital with COVID-19 are poorly presented and are at high risk of selection bias. The aim of the study was to propose a prediction clinical tool to predict an unfavourable outcome at the admission of a SARS-CoV2 infected patient that was carefully developed using a large learning database and that was developed from models derived from artificial intelligence.Methods. The PREDICT-COVID study is a post hoc analysis of the Noso-Cor study, a multicenter prospective, observational study. All patients infected by SARS-CoV2 hospitalized in one of the 11 Lyon-University hospitals since 8-March-2020 have been included. The PREDICT-COVID database was split in two separate datasets: the learning dataset (80%) was used for the development of the model and the validation dataset (20%) for internal validation. The primary composite outcome was the need for mechanical ventilation or admission into an intensive care unit, or death within 21 days of admission.Results. Data from 823 patients were analysed: age 70.6±16·9 years; body mass index 26.7±5·4 kg/m2 and median number of comorbidities was 2. Out of the 44 recorded variables, 11 that were the most linked to the primary outcome criteria were retained to develop the optimised risk prediction tool. At admission the 5 most informative predictors were, in descending order: C-Reactive Protein, neutrophil-to-lymphocyte ratio, aspartate transaminase, shortness of breath, and prothrombin time. The ten-fold cross validation of the optimised model had an area under the ROC curve of 0.76±0.06. The performance of the developed Bayesian model to predict the primary outcome of the validation dataset had a mean area under the ROC curve of 0.78, sensitivity of 60%, and specificity of 77%.Conclusions. The proposed optimised prediction tool that uses 11 routinely determined variables to predict an unfavourable course at admission for COVID-19 had satisfactory performance. For an external validation, the PREDICT-COVID prediction tool is available online at: https://www.hed.cc/?a=covid&n=NETCRIT21J.netaTrial registration: The Noso-Cor study was registered on ClinicalTrials (NCT04290780). The present analysis was registered on ClinicalTrials (NCT04412031) the June 2, 2020.

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“…18,28,31,39,[41][42][43]46,47,50,52,53,57,61,63,64,[69][70][71][72][73] The immunopathogenesis of SARS-CoV-2 infection is typified by an aggressive inflammatory response, 74 and accordingly, elevated inflammatory markers are common. 18,28,[41][42][43]46,47,50,52,61,63,64,[69][70][71][72] Lymphopaenia and an increased neutrophil to lymphocyte ratio can occur in many patients with SARS-CoV-2 infection. 37,52,74 Close monitoring of inflammatory markers and serum cytokine and chemokine levels is crucial to the optimal management of COVID-19 patients, 37,75 as severe SARS-CoV-2 infection can result in the manifestation of a cytokine storm syndrome.…”

Section: Symptoms Associated With Covid-19mentioning

confidence: 99%

Screening and testing for COVID‐19 before surgery

Kovoor

Tivey

Williamson

et al. 2020

ANZ Journal of Surgery

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Background: Preoperative screening for coronavirus disease 2019 (COVID-19) aims to preserve surgical safety for both patients and surgical teams. This rapid review provides an evaluation of current evidence with input from clinical experts to produce guidance for screening for active COVID-19 in a low prevalence setting. Methods: An initial search of PubMed (until 6 May 2020) was combined with targeted searches of both PubMed and Google Scholar until 1 July 2020. Findings were streamlined for clinical relevance through the advice of an expert working group that included seven senior surgeons and a senior medical virologist. Results: Patient history should be examined for potential exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hyposmia and hypogeusia may present as early symptoms of COVID-19, and can potentially discriminate from other influenza-like illnesses. Reverse transcription-polymerase chain reaction is the gold standard diagnostic test to confirm SARS-CoV-2 infection, and although sensitivity can be improved with repeated testing, the decision to retest should incorporate clinical history and the local supply of diagnostic resources. At present, routine serological testing has little utility for diagnosing acute infection. To appropriately conduct preoperative testing, the temporal dynamics of SARS-CoV-2 must be considered. Relative to other thoracic imaging modalities, computed tomography has the greatest utility for characterizing pulmonary involvement in COVID-19 patients who have been diagnosed by reverse transcription-polymerase chain reaction. Conclusion: Through a rapid review of the literature and advice from a clinical expert working group, evidence-based recommendations have been produced for the preoperative screening of surgical patients with suspected COVID-19.

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Clinical characteristics of coronavirus disease (COVID-19) early findings from a teaching hospital in Pavia, North Italy, 21 to 28 February 2020

Cited by 134 publications

References 20 publications

Partial compliance with symptom-based testing pathways reveals asymptomatic carriage of SARS-CoV-2 in Ireland

Partial compliance with symptom-based testing pathways reveals asymptomatic carriage of SARS-CoV-2 in Ireland

Predicting an Unfavourable Course in Patients Hospitalised for COVID-19: The PREDICT-COVID Study

Screening and testing for COVID‐19 before surgery

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