Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic: a prospective observational study
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Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic: a prospective observational study. / Thibeault, Charlotte; Mühlemann, Barbara; Helbig, Elisa T; Mittermaier, Mirja; Lingscheid, Tilman; Tober-Lau, Pinkus; Meyer-Arndt, Lil A; Meiners, Leonie; Stubbemann, Paula; Haenel, Sascha S; Bosquillon de Jarcy, Laure; Lippert, Lena; Pfeiffer, Moritz; Stegemann, Miriam S; Roehle, Robert; Wiebach, Janine; Hippenstiel, Stefan; Zoller, Thomas; Müller-Redetzky, Holger; Uhrig, Alexander; Balzer, Felix; von Kalle, Christof; Suttorp, Norbert; Jones, Terry C; Drosten, Christian; Witzenrath, Martin; Sander, Leif E; Corman, Victor M; Kurth, Florian; Pa-COVID Study Group.
In: INFECTION, Vol. 49, No. 4, 08.2021, p. 703-714.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic: a prospective observational study
AU - Thibeault, Charlotte
AU - Mühlemann, Barbara
AU - Helbig, Elisa T
AU - Mittermaier, Mirja
AU - Lingscheid, Tilman
AU - Tober-Lau, Pinkus
AU - Meyer-Arndt, Lil A
AU - Meiners, Leonie
AU - Stubbemann, Paula
AU - Haenel, Sascha S
AU - Bosquillon de Jarcy, Laure
AU - Lippert, Lena
AU - Pfeiffer, Moritz
AU - Stegemann, Miriam S
AU - Roehle, Robert
AU - Wiebach, Janine
AU - Hippenstiel, Stefan
AU - Zoller, Thomas
AU - Müller-Redetzky, Holger
AU - Uhrig, Alexander
AU - Balzer, Felix
AU - von Kalle, Christof
AU - Suttorp, Norbert
AU - Jones, Terry C
AU - Drosten, Christian
AU - Witzenrath, Martin
AU - Sander, Leif E
AU - Corman, Victor M
AU - Kurth, Florian
AU - Pa-COVID Study Group
N1 - © 2021. The Author(s).
PY - 2021/8
Y1 - 2021/8
N2 - PURPOSE: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course.METHODS: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed.RESULTS: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10-1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00-16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26-46.75, vs 18 days, IQR 16-46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6-15.5) for non-IMV and 49.5 days (IQR 36.8-82.5) for IMV patients.CONCLUSIONS: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19.
AB - PURPOSE: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course.METHODS: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed.RESULTS: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10-1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00-16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26-46.75, vs 18 days, IQR 16-46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6-15.5) for non-IMV and 49.5 days (IQR 36.8-82.5) for IMV patients.CONCLUSIONS: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19.
KW - COVID-19/epidemiology
KW - Cohort Studies
KW - Germany/epidemiology
KW - Hospitalization
KW - Humans
KW - Hypertension/complications
KW - Kinetics
KW - Prospective Studies
KW - Respiration, Artificial
KW - Risk Factors
KW - SARS-CoV-2/physiology
KW - Tertiary Care Centers
KW - Time Factors
KW - Viral Load
KW - Virus Shedding
U2 - 10.1007/s15010-021-01594-w
DO - 10.1007/s15010-021-01594-w
M3 - SCORING: Journal article
C2 - 33890243
VL - 49
SP - 703
EP - 714
JO - INFECTION
JF - INFECTION
SN - 0300-8126
IS - 4
ER -
