Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19
Comprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/8/1562 |
| _version_ | 1797538474145873920 |
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| author | Alyssa Ylescupidez Aaron Rips Henry T. Bahnson Cate Speake Punam Verma Anne M. Hocking Jane H. Buckner Uma Malhotra |
| author_facet | Alyssa Ylescupidez Aaron Rips Henry T. Bahnson Cate Speake Punam Verma Anne M. Hocking Jane H. Buckner Uma Malhotra |
| author_sort | Alyssa Ylescupidez |
| collection | DOAJ |
| description | Comprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospitalization. Three broad patient phenotypes and four symptom clusters were characterized, differentiated by varying risk for adverse outcomes. Among 14 symptoms assessed, subjective shortness of breath (SOB) most strongly associated with adverse outcomes (odds ratio (OR) 21.3, 95% confidence interval (CI): 2.7–166.4; <i>p</i> < 0.0001). In combination, SOB and number of comorbidities were highly predictive of subsequent hospitalization (area under the curve (AUC) 92%). Additionally, initial lymphopenia (OR 21.0, 95% CI: 2.1–210.1; <i>p</i> = 0.002) and male sex (OR 3.5, 95% CI: 0.9–13.0; <i>p</i> = 0.05) were associated with increased risk of poor outcomes. Patients with known comorbidities, especially multiple, and those presenting with subjective SOB or lymphopenia should receive close monitoring and consideration for preemptive treatment, even when presenting with mild symptoms. |
| first_indexed | 2024-03-10T12:30:53Z |
| format | Article |
| id | doaj.art-6778f702be3d4f35a5ed4f436bde642c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:30:53Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6778f702be3d4f35a5ed4f436bde642c2023-11-21T14:37:33ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01108156210.3390/jcm10081562Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19Alyssa Ylescupidez0Aaron Rips1Henry T. Bahnson2Cate Speake3Punam Verma4Anne M. Hocking5Jane H. Buckner6Uma Malhotra7Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USACenter for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USACenter for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USACenter for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USADepartment of Microbiology, Virginia Mason Medical Center, Seattle, WA 98101, USACenter for Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USACenter for Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USADepartment of Infectious Disease, Virginia Mason Medical Center, Seattle, WA 98101, USAComprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospitalization. Three broad patient phenotypes and four symptom clusters were characterized, differentiated by varying risk for adverse outcomes. Among 14 symptoms assessed, subjective shortness of breath (SOB) most strongly associated with adverse outcomes (odds ratio (OR) 21.3, 95% confidence interval (CI): 2.7–166.4; <i>p</i> < 0.0001). In combination, SOB and number of comorbidities were highly predictive of subsequent hospitalization (area under the curve (AUC) 92%). Additionally, initial lymphopenia (OR 21.0, 95% CI: 2.1–210.1; <i>p</i> = 0.002) and male sex (OR 3.5, 95% CI: 0.9–13.0; <i>p</i> = 0.05) were associated with increased risk of poor outcomes. Patients with known comorbidities, especially multiple, and those presenting with subjective SOB or lymphopenia should receive close monitoring and consideration for preemptive treatment, even when presenting with mild symptoms.https://www.mdpi.com/2077-0383/10/8/1562COVID-19SARS CoV-2pathophysiologyprognostic indicatorspandemiccomorbidities |
| spellingShingle | Alyssa Ylescupidez Aaron Rips Henry T. Bahnson Cate Speake Punam Verma Anne M. Hocking Jane H. Buckner Uma Malhotra Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19 Journal of Clinical Medicine COVID-19 SARS CoV-2 pathophysiology prognostic indicators pandemic comorbidities |
| title | Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19 |
| title_full | Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19 |
| title_fullStr | Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19 |
| title_full_unstemmed | Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19 |
| title_short | Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19 |
| title_sort | early prognostic indicators of subsequent hospitalization in patients with mild covid 19 |
| topic | COVID-19 SARS CoV-2 pathophysiology prognostic indicators pandemic comorbidities |
| url | https://www.mdpi.com/2077-0383/10/8/1562 |
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