Individual Characteristics as Prognostic Factors of the Evolution of Hospitalized COVID-19 Romanian Patients: A Comparative Observational Study between the First and Second Waves Based on Gaussian Graphical Models and Structural Equation Modeling

Abstract

This study examines the role played by individual characteristics and specific treatment methods in the evolution of hospitalized patients with coronavirus disease 2019 (COVID-19), through the lens of an observational study performed in a comparative approach between the first and second waves of coronavirus pandemic in Romania. The research endeavor is configured on a two-fold approach, including a detailed observation of the evolution of 274 hospitalized patients with COVID-19 (145 in the first wave and 129 in the second wave of infection) according to specific treatment methods applied and patients’ individual features, as well as an econometric (quantitative) analysis through structural equation modeling and Gaussian graphical models designed to acknowledge the correlations and causal relationship between all considered coordinates. The main results highlight that the specific treatment methods applied had a positive influence on the evolution of COVID-19 patients, particularly in the second wave of coronavirus pandemic. In case of the first wave of COVID-19 infection, GGM results entail that there is a strong positive correlation between the evolution of the patients and the COVID-19 disease form, which is further positively correlated with the treatment scheme. The evolution of the patients is strongly and inversely correlated with the symptomatology and the ICU hospitalization. Moreover, the disease form is strongly and inversely correlated with oxygen saturation and the residence of patients (urban/rural). The symptomatology at first appearance also strongly depends on the age of the patients (positive correlation) and of the fact that the patient is a smoker or non-smoker and has other comorbidities. Age and gender are also important credentials that shape the disease degree and patient evolution in responding to treatment as well, our study attesting strong interconnections between these coordinates, the form of disease, symptomatology and overall evolution of the patients.

Laboratory Findings and Clinical Outcomes of ICU-admitted COVID-19 Patients: A Retrospective Assessment of Particularities Identified among Romanian Minorities

“…The most common symptoms of COVID-19 are generally nonspecific, including high prevalence rates of fever, tiredness, and a dry cough. On the other hand, interstitial pneumonia, thrombo-embolic events, and acute respiratory distress syndrome (ARDS) are all outcomes and possible severe manifestations of SARS-CoV-2 infection among populations at risk [ 4 , 5 , 6 , 7 , 8 ]. These forms of COVID-19 are likely to be triggered by an overactivation of the immune system, causing a cytokine storm [ 9 , 10 , 11 , 12 ].…”

Prevalence and association of oral manifestations with disease severity in patients diagnosed with COVID‑19: A cross‑sectional study

“…Based on the data derived from genetic and epidemiological studies, it is evident that the onset of the COVID-19 epidemic may be attributed to an initial instance of zoonotic transmission, subsequently leading to continuous human-to-human transmission ( 32 ). It is well known that the transmission of the virus mostly occurs via the upper respiratory tract ( 33 ). Furthermore, it is worth noting that there exists a potential for fecal-oral transmission, since scientific investigations have successfully detected the presence of SARS-CoV-2 in the feces of individuals originating from China and the USA ( 34 ).…”

Clinical-epidemiologic variation in patients treated in the first and second wave of COVID-19 in Lambayeque, Peru: A cluster analysis

“…The clinical presentation of COVID-19 includes cough, nasal congestion, fever, chest pain, and shortness of breath (Griffin et al, 2021;Jiang et al, 2020), varying according to the level of clinical classification (mild, moderate, severe, and critical) (Instituto de Evaluación de Tecnologías en Salud e Investigación, 2021). Previous studies have described clinical differences between the first and second waves, particularly in age groups, symptomatology, and disease severity (Area et al, 2021;Friston et al, 2021;Iftimie et al, 2021;Mocanu et al, 2021;Mollinedo-Gajate et al, 2021;Salyer et al, 2021;Soriano et al, 2021;Vinceti et al, 2021).…”