The General Characteristics of Hospitalized Patients with the Diagnosis of COVID-19, and the Relationship between Presenting Symptoms and Clinical Course: A Single Center Experience

Year 2022, Volume: 7 Issue: 4, 511 - 516, 10.12.2022

Kubilay İşsever Deniz Çekiç Erkut Etçioğlu Ahmed Cihad Genç Ahmed Bilal Genç Selcuk Yaylacı

https://doi.org/10.26453/otjhs.1022906

Abstract

Objective: In this study, it was aimed to reveal the relationship between the clinical features, presenting symptoms, and prognosis of COVID-19 patients who were hospitalized in our center.

Materials and Methods: 499 patients with the diagnosis of COVID-19 followed in the service and intensive care units of Sakarya University Training and Research Hospital between March 2020 and January 2021 were included in the study. The clinical and demographical data of the patients were obtained from the patient files and hospital automation system. The obtained data were analyzed statistically.

Results: Of 499 patients, 171 were followed up in the ward and 328 in the intensive care unit. Follow-up of 230 patients resulted in death, while 269 patients were discharged. Comorbid diseases were found to be more frequently seen in the mortal group (p<0.05). Mean leukocyte, neutrophil, c-reactive protein (CRP), procalcitonin (PCT), lactate dehydrogenase (LDH), ferritin, d-dimer, and troponin values ​​were higher in the mortal group; whereas mean lymphocyte value was found to be lower (p<0.05). While fever, cough, and other less common symptoms (diarrhea, nausea, muscle weakness, etc.) were more frequently seen in the non-mortal group ( p=0.022, p=0.038, and p=0.000 respectively), shortness of breath was significantly more common in the mortal group (p=0.000). The frequency of symptoms such as sputum, fatigue, sore throat, and the headache were found to be similar in both groups (p>0.05).

Conclusion: It was concluded that the clinical course of patients with dyspnea at admission may be more severe and these patients should be followed more closely.

Keywords

COVID-19, PROGNOSIS, mortality, symptoms

COVID-19 Tanısıyla Hastaneye Yatan Hastaların Genel Karakteristik Özellikleri ve Başvuru Semptomları ile Klinik Seyirleri Arasındaki İlişki: Tek Merkez Deneyimi

Abstract

Amaç: Bu çalışmada merkezimizde yatarak tedavi edilmiş hastaların klinik özellikleri ve başvuru semptomları ile prognozları arasındaki ilişkinin ortaya konulması amaçlanmıştır.

Materyal ve Metot: Mart 2020- Ocak 2021 arasında Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi’nde servis ve yoğun bakımlarda COVID-19 tanısıyla takip edilen 499 hasta çalışmaya dahil edildi. Hastaların klinik ve demografik verileri hasta dosyaları ve hastane otomasyon sisteminden elde edildi. Elde edilen veriler istatistiksel olarak değerlendirildi.

Bulgular: 499 hastanın 171’i serviste, 328’i yoğun bakımda takip edilmiştir. 230 hastanın takibi ölümle sonuçlanırken 269 hasta taburcu edilmiştir. Komorbid hastalıklar mortal grupta anlamlı ölçüde daha sık rastlanmıştır (p<0,5). Mortal grupta, ortalama lökosit, nötrofil, c-reaktif protein (CRP), prokalsitonin (PCT), laktat dehidrogenaz (LDH), ferritin, d-dimer ve troponin değerleri daha yüksek; ortalama lenfosit değeri daha düşük saptandı (p<0,05). Başvuru semptomlarından ateş, öksürük ve daha nadir görülen diğer semptomlar (ishal,bulantı, kas güçsüzlüğü vs.) non-mortal grupta daha sık saptanırken (sırasıyla p=0,022, p=0,038 ve p=0,000) nefes darlığı mortal grupta anlamlı ölçüde daha sık saptandı (p=0,000). Balgam, halsizlik, boğaz ağrısı ve baş ağrısı semptomlarının sıklığı her iki grupta benzer olarak bulundu (p>0,05).

Sonuç: Başvuru esnasında nefes darlığı şikayeti olan hastaların klinik seyrinin daha şiddetli olabileceği ve bu hastaların daha yakından takip edilmesi gerektiği sonucuna varılmıştır. 

Keywords

COVID-19, SEMPTOM, PROGNOZ, MORTALİTE, mortality, symptoms

References

• Majumder J, Minko T. Recent developments on therapeutic and diagnostic approaches for COVID-19. AAPS J. 2021;23:14. doi:10.1208/s12248-020-00532-2
• Huang C, Wang Y, Li X, ve ark. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506. doi:10.1016/S0140-6736(20)30183-5
• T.C. Sağlık Bakanlığı COVID-19 Bilgilendirme Platformu. Genel Koronavirüs Tablosu 2021. https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html. Erişim tarihi 15 Temmuz 2021.
• Li C, Ji F, Wang L, ve ark. Asymptomatic and human-to-human transmission of SARS-CoV-2 in a 2-family cluster, Xuzhou, China. Emerg Infect Dis. 2020;26(7):1626-1628. doi:10.3201/eid2607.200718
• Zhu N, Zhang D, Wang W, ve ark. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–733. doi:10.1056/NEJMoa2001017
• Xu X, Wu X, Jiang X, ve ark. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: Retrospective case series. BMJ. 2020;368:m606 doi:10.1136/bmj.m606
• Chen N, Zhou M, Dong X, ve ark. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395(10223):507-513. doi:10.1016/S0140-6736(20)30211-7
• Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the chinese center for disease control and prevention. JAMA. 2020;323(13):1239-1242. doi:10.1001/jama.2020.2648.
• Han C, Duan C, Zhang S, ve ark. Digestive symptoms in COVID-19 patients with mild disease severity: Clinical presentation, stool viral RNA testing, and outcomes. Am J Gastroenterol. 2020;115:916–923. doi:10.14309/ajg.0000000000000664
• Pan L, Mu M, Yang P, ve ark. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115(5):766-773. doi:10.14309/ajg.0000000000000620
• Gallo MB, Aghagoli G, Lavine K, ve ark. Predictors of COVID-19 severity: A literature review. Rev Med Virol. 2021;31:1–10. doi:10.1002/rmv.2146
• Avcı E. , Ardahanlı İ. , Öztaş E. , Dişibeyaz S. COVID-19'da gastrointestinal semptomlar ile hastalığın seyri ve prognozu arasında bir ilişki var mı? Tek merkezli pilot çalışma. Akademik Gastroenteroloji Dergisi. 2020;19(3):103-108. doi:10.17941/agd.847338
• Guan WJ, Ni ZY, Hu Y, ve ark. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708–1720. doi:10.1056/NEJMoa2002032
• Iaccarino G, Grassi G, Borghi C, ve ark. Age and multimorbidity predict death among COVID-19 patients: Results of the SARS-RAS study of the Italian society of hypertension. Hypertension 2020;76:366–372. doi:10.1161/HYPERTEN SIONAHA.120. 15324
• Zheng Z, Peng F, Xu B, ve ark. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020;81:e16–e25. doi:10.1016/j.jinf.2020.04.021
• Zhu B, Feng X, Jiang C, ve ark. Correlation between white blood cell count at admission and mortality in COVID-19 patients: A retrospective study. BMC Infect Dis. 2021;21:574. doi: 10.1186/s12879-021-06277-3
• Khinda J, Janjua NZ, Cheng S, Van Den Heuvel ER, Bhatti P, Darvishian M. Association between markers of immune response at hospital admission and COVID-19 disease severity and mortality: A meta-analysis and meta-regression. J Med Virol. 2021;93:1078–1098. doi: 10.1002/jmv.26411
• Siripanthong B, Nazarian S, Muser D, ve ark. Recognizing COVID-19-related myocarditis: The possible pathophysiology and proposed guideline for diagnosis and management. Heart Rhythm. 2020;17:1463–1471. doi:10.1016/j.hrthm.2020.05.001
• Fuchs TA, Brill A, Wagner DD. Neutrophil extracellular trap (NET) impact on deep vein thrombosis. Arterioscler Thromb Vasc Biol. 2012;32:1777–1783. doi:10.1161/ATVBAHA.111.242859
• Zhao Q, Meng M, Kumar R, ve ark. Lymphopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A systemic review and meta-analysis. Int J Infect Dis. 2020;96:131–135. doi:10.1016/j.ijid.2020.04.086
• Ng DHL, Choy CY, Chan YH, ve ark. Fever Patterns, Cytokine Profiles, and Outcomes in COVID-19. Open Forum Infect Dis. 2020;7:ofaa375. doi:10.1093/ofid/ofaa375
• Bavaro DF, Diella L, Fabrizio C, ve ark. Peculiar clinical presentation of COVID-19 and predictors of mortality in the elderly: A multicentre retrospective cohort study. Int J Infect Dis. 2021;105:709–715. doi:10.1016/j.ijid.2021