The interval between onset and admission predicts disease progression in COVID-19 patients

Abstract

Background: The prognostic role of the interval between disease onset and hospital admission (O-A interval) was undetermined in patients with the coronavirus disease 2019 (COVID-19). Methods: A total of 205 laboratory-confirmed inpatients admitted to Hankou hospital of Wuhan from January 11 to March 8, 2020 were consecutively included in this retrospective observational study. Demographic data, medical history, laboratory testing results were collected from medical records. Univariate and multivariate logistic regression models were used to evaluate the prognostic effect of the O-A interval (≤7 versus >7 days) on disease progression in mild-to-moderate patients. For severe-to-critical patients, the in-hospital mortality and the length of hospital stay were compared between the O-A interval subgroups using log-rank test and Mann-Whitney U test, respectively. Results: Mild-to-moderate patients with a short O-A interval (≤7 days) are more likely to deteriorate to severe-to-critical stage compared to those with a long O-A interval (>7 days) [unadjusted odds ratio =2.93, 95% confidence interval (CI), 1.32-6.55; adjusted odds ratio =3.44, 95% CI, 1.20-9.83]. No association was identified between the O-A interval and the mortality or the length of hospital stay of severe-to-critical patients. Conclusions: The O-A interval has predictive values for the disease progression in mild-to-moderate COVID-19 patients. Under circumstances of the specific health system in Wuhan, China, the spontaneous healthcare-seeking behavior is usually determined by patients' own heath conditions. Hence, the O-A interval can be reflective of the natural course of COVID-19 to some extent. However, our findings should be validated further in other cohorts and in other health systems.

Factors associated with prolonged viral shedding of SARS‐CoV‐2 Omicron variant infection in Shanghai: A multicenter, retrospective, observational study

“…Consistent with our findings, previous research has shown that delayed hospital admissions correlate with prolonged SARS‐CoV‐2 RNA shedding time 17 . Moreover, prior research indicates that patients with early hospital admissions experience milder COVID‐19 progression 25 . Taken together, these findings underscore the importance of individuals seeking immediate hospital care upon confirmation of SARS‐CoV‐2 infection.…”

The role of IL-6, ferritin, and coagulopathy in Covid-19 clinical progression

“…Peng et al reported that the O-A interval less than 7 days predict the likelihood of disease progression in moderate-severe disease Covid 19. 27 But limitations were stated in aforementioned study that the health-seeking behavior of the patient and the domestic health system might influence the admission interval, aside from selection bias and confounding factors.…”

Prone position reduces the risk of patients with mild or moderate COVID-19 progressing to severe or even critical cases: a retrospective study

“…Other studies have shown that prone position may be more effective when performed early than later [10,43]. It has also been shown that the earlier patients are admitted to hospital for intervention, the less likely mild and moderate cases will progress to severe and critical [44]. However, there are few studies concerning whether it is possible to reduce the percentage of conversion to severe and critical cases if prone position was performed on the day of admission in mild and moderate patients.…”