Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: a comparison of patients with and without COVID-19

Shah, Sachin J; Barish, Peter N; Prasad, Priya; Kistler, Amy; Neff, Norma; Kamm, John A.; Li, Lucy M; Chiu, Charles Y.; Babick, Jennifer M; Fang, Margaret C.; Abe-Jones, Yumiko; Alipanah, Narges; Alvarez, Francisco N.; Botvinnik, Olga; Davis, Jennifer; Castenada, Gloria D; Dadasovich, Rand; DeRisi, Joseph L.; Detweiler, Angela M.; Federman, Scot; Haliburton, John; Hao, Samantha; Kerkhoff, Andrew D.; Kumar, Renuka; Malcolm, Katherine; Mann, Sabrina A; Martínez, Sandra; Marya, Rupa; Mick, Eran; Mwakibete, Lusajo; Najafi, Nader; Peluso, Michael J.; Phelps, Maíra; Pisco, Angela Oliveira; Ratnasiri, Kalani; Rubio, Luis; Sellas, Anna B.; Sherwood, Kyla D; Sheu, Jonathan; Spottiswoode, Natasha; Tan, Michelle; Yu, Guixa; Kangelaris, Kirsten N.; Langelier, Charles

doi:10.1101/2020.05.02.20082461

Cited by 19 publications

(24 citation statements)

References 48 publications

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“…In a study of 1420 European patients with COVID-19, elderly patients were more likely to have myalgia, fatigue, and fever as compared with younger patients who had higher propensity to acquire symptoms related to ear, nose, and throat [13]. As compared with COVID-19-negative patients, COVID-19-positive patients with respiratory illness reported longer symptom duration (median 7 vs. 3 days), higher prevalence of fever (82% vs. 44%), fatigue (85% vs. 50%), and myalgias (61% vs 27%) [90]. Myalgia persisted at the median time of 23 days of cessation of viral shedding.…”

Section: Myalgiamentioning

confidence: 96%

Neuromuscular presentations in patients with COVID-19

et al. 2020

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COVID-19 is caused by the coronavirus SARS-CoV-2 that has an affinity for neural tissue. There are reports of encephalitis, encephalopathy, cranial neuropathy, Guillain-Barrè syndrome, and myositis/rhabdomyolysis in patients with COVID-19. In this review, we focused on the neuromuscular manifestations of SARS-CoV-2 infection. We analyzed all published reports on SARS-CoV-2-related peripheral nerve, neuromuscular junction, muscle, and cranial nerve disorders. Olfactory and gustatory dysfunction is now accepted as an early manifestation of COVID-19 infection. Inflammation, edema, and axonal damage of olfactory bulb have been shown in autopsy of patients who died of COVID-19. Olfactory pathway is suggested as a portal of entry of SARS-CoV-2 in the brain. Similar to involvement of olfactory bulb, isolated oculomotor, trochlear and facial nerve has been described. Increasing reports Guillain-Barrè syndrome secondary to COVID-19 are being published. Unlike typical GBS, most of COVID-19-related GBS were elderly, had concomitant pneumonia or ARDS, more prevalent demyelinating neuropathy, and relatively poor outcome. Myalgia is described among the common symptoms of COVID-19 after fever, cough, and sore throat. Duration of myalgia may be related to the severity of COVID-19 disease. Few patients had muscle weakness and elevated creatine kinase along with elevated levels of acute-phase reactants. All these patients with myositis/rhabdomyolysis had severe respiratory complications related to COVID-19. A handful of patients with myasthenia gravis showed exacerbation of their disease after acquiring COVID-19 disease. Most of these patients recovered with either intravenous immunoglobulins or steroids.

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Section: Myalgiamentioning

confidence: 96%

Neuromuscular presentations in patients with COVID-19

et al. 2020

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“…We are only aware of one other study comparing ED presentations in this way – a small single centre study from San Francisco showing no difference in mortality. [16]…”

Section: Discussionmentioning

confidence: 99%

Characterisation of 22446 patients attending UK emergency departments with suspected COVID-19 infection: Observational cohort study

Goodacre

Thomas

Lee

et al. 2020

Preprint

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Background Hospital emergency departments play a crucial role in the initial management of suspected COVID-19 infection. We aimed to characterise patients attending emergency departments with suspected COVID-19, including subgroups based on sex, ethnicity and COVID-19 test results. Methods We undertook a mixed prospective and retrospective observational cohort study in 70 emergency departments across the United Kingdom (UK). We collected presenting data from 22446 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. Outcomes were admission to hospital, COVID-19 result, organ support (respiratory, cardiovascular or renal), and death, by record review at 30 days. Results Adults were acutely unwell (median NEWS2 score 4) and had high rates of admission (67.1%), COVID-19 positivity (31.2%), organ support (9.8%) and death (15.9%). Children had much lower rates of admission (27.4%), COVID-19 positivity (1.2%), organ support (1.4%) and death (0.3%). Adult men and women presented in similar numbers (10210 versus 10506), but men were more likely to be admitted (72.9% v 61.4%), require organ support (12.2% v 7.7%) and die (18.7% v 13.3%). Black or Asian adults tended to be younger than White adults (median age 54, 50 and 67 years), were less likely to be admitted (60.8%, 57.3%, 69.6%) or die (11.9%, 11.2%, 16.8%), but were more likely to require organ support (15.9%, 14.3%, 8.9%) or have a positive COVID-19 test (40.8%, 42.1%, 30.0%). Adults admitted with confirmed COVID-19 had similar age and comorbidities (except chronic lung disease) to those who did not have COVID-19 confirmed, but were much more likely to need organ support (22.2% v 8.9%) or die (32.7% v 15.9%). Conclusions Important differences exist between patient groups presenting to the emergency department with suspected COVID-19. People with confirmed COVID-19 have a poor prognosis, compared with similar emergency admissions without confirmed COVID-19.

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“…[ 14 ] Duration of hospitalization (days) 11 days Guan et al., [ 19 ] Docherty et al., [ 20 ] Shah et al. [ 21 ] Per-contact probability of infection (households) 0.024 Estimated from model fitting Per-contact probability of infection (non-household locations) 0.008 Estimated from model fitting …”

Section: Methodsmentioning

confidence: 99%

“…Infectious individuals have an age-specific probability of being hospitalized; probabilities range from 0.1% among agents aged <1 year to 30% among those aged 99 years, based on age-specific incidence of COVID-19 hospitalization in Washington and California [ 17 ]. Hospitalized agents enter the hospital 3–5 days after onset of symptoms [ 18 ] and are hospitalized for an average of 11 days [ [19] , [20] , [21] ]. Transmission in hospital settings is ignored.…”

Section: Methodsmentioning

confidence: 99%

Low-impact social distancing interventions to mitigate local epidemics of SARS-CoV-2

Jackson

2020

Microbes and Infection

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Many jurisdictions implemented intensive social distancing to suppress SARS-CoV-2 transmission. The challenge now is to mitigate the ongoing COVID-19 epidemic without overburdening economic and social activities. An agent-based model simulated the population of King County, Washington. SARS-CoV-2 transmission probabilities were estimated by fitting simulated to observed hospital admissions. Interventions considered included encouraging telecommuting, reducing contacts to high-risk persons, and reductions to contacts outside of the home, among others. Removing all existing interventions would result in nearly 42,000 COVID-19 hospitalizations between June 2020 and January 2021, with peak hospital occupancy exceeding available beds 6-fold. Combining interventions is predicted to reduce total hospitalizations by 48% (95% CI, 47–49%), with peak COVID-19 hospital occupancy of 70% of total beds. Targeted school closures can further reduce the peak occupancy. Combining low-impact interventions may mitigate the course of the COVID-19 epidemic, keeping hospital burden within the capacity of the healthcare system.

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Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: a comparison of patients with and without COVID-19

Abstract: 1

Cited by 19 publications

References 48 publications

Neuromuscular presentations in patients with COVID-19

Neuromuscular presentations in patients with COVID-19

Characterisation of 22446 patients attending UK emergency departments with suspected COVID-19 infection: Observational cohort study

Low-impact social distancing interventions to mitigate local epidemics of SARS-CoV-2

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