Epidemiology, risk factors and clinical course of SARS-CoV-2 infected patients in a Swiss university hospital: an observational retrospective study

Abstract

Background Coronavirus disease 2019 (COVID-19) is now a global pandemic with Europe and the USA at its epicenter. Little is known about risk factors for progression to severe disease in Europe. This study aims to describe the epidemiology of COVID-19 patients in a Swiss university hospital. Methods This retrospective observational study included all adult patients hospitalized with a laboratory confirmed SARS-CoV-2 infection from March 1 to March 25, 2020. We extracted data from electronic health records. The primary outcome was the need to mechanical ventilation at day 14. We used multivariate logistic regression to identify risk factors for mechanical ventilation. Follow-up was of at least 14 days. Results 200 patients were included, of whom 37 (18.5%) needed mechanical ventilation at 14 days. The median time from symptoms onset to mechanical ventilation was 9.5 days (IQR 7.00, 12.75). Multivariable regression showed increased odds of mechanical ventilation in males (3.26, 1.21-9.8; p=0.025), in patients who presented with a qSOFA score ≥2 (6.02, 2.09-18.82; p=0.001), with bilateral infiltrate (5.75, 1.91-21.06; p=0.004) or with a CRP of 40 mg/l or greater (4.73, 1.51-18.58; p=0.013). Conclusions This study gives some insight in the epidemiology and clinical course of patients admitted in a European tertiary hospital with SARS-CoV-2 infection. Male sex, high qSOFA score, CRP of 40 mg/l or greater and a bilateral radiological infiltrate could help clinicians identify patients at high risk for mechanical ventilation.

Outcomes for Patients With COVID-19 and Acute Kidney Injury: A Systematic Review and Meta-Analysis

“…16,28,30,38,39 After accounting for potential overlapping patient cohorts in these smaller studies, we identified 20 unique cohorts encompassing 13,137 patients with available kidney disease-related information. 4,[12][13][14][15][19][20][21][22][23][24]26,30,32,33,[35][36][37][38][39] Of these 20 cohorts included in the statistical analysis, 13 were from China, 1 was from Korea, 3 were from the United States, and 3 were from Europe. The quality of peer-reviewed studies and preprint studies were similar (Supplementary Table S1).…”

“…Four studies reported the prevalence of the use of renin-angiotensin-aldosterone system inhibition before admission (24%; range, 11.5%-32%). 19,22,24,26 The prevalence of AKI across the 20 cohorts was 17%, with a range of 0.5% to 80.3% (Table 2). 3,4, Six studies provided a breakdown of the severity of AKI using Kidney Disease: Improving Global Outcomes staging (15% stage 1, 7% stage 2, 11% stage 3), with Xiao et al 32 not differentiating between stage 2 and stage 3 (data were only used for stage 1).…”

Charlson comorbidity index and a composite of poor outcomes in COVID-19 patients: A systematic review and meta-analysis

“…A total of 20 studies were included in the qualitative and quantitative synthesis ( Fig. 1 , Table 1 ) [ 2 , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ]. One study which we included described an OR value.…”

Lack of association of antihypertensive drugs with the risk and severity of COVID-19: A meta-analysis

“…There was an equal number of males and females for most studies, however, one study had 90.2% male participants [ 18 ] and another had 28% male participants [ 19 ]. On average, most studies included middle-aged participants, but three trended more toward elderly participants [ [20] , [21] , [22] ]. Study durations varied, with the shortest being 14 days and the longest being 145 days.…”