Which COVID-19 patients should be recommended for home isolation and which should be hospitalized? Predictors of disease progression for mild COVID-19 patients

Yıl 2021, Cilt: 38 Sayı: 4, 490 - 495, 09.10.2021

Gökhan Aksel Enis Ademoğlu Mehmet Muzaffer İslam Gökselin Beleli Yaşar Deniz Tengerek Mustafa Ümit Can Dölek Salih Daşdelen Serkan Emre Eroğlu

Öz

Background/aim: Each country has different treatment and home isolation recommendations regarding the management of mild COVID-19 patients, and there is not yet a standard approach. The aim of this study is to determine which patients are suitable for home isolation by identifying the variables that predict the progression of the disease in mild COVID-19 patients.
Materials and methods: This prospective observational study included laboratory confirmed mild COVID-19 patients older than 18 years. The primary outcome of the study was the disease progression in mild COVID-19 patients. A multivariate regression model was created according to the results of univariate analyses.
Results: A total of 254 patients included in the study. Median age of the patients was 34.5 years (27–42), and 132 (52%) of them were male. COVID-19 compatible thoracic computed tomography appearance (P<0.001, HR=6.58, 95% CI=2,60-16,65) and advanced age (P=0.008, HR=1.07, 95% CI=1.02-1.13) were significantly associated with the progression of the disease, and the use of hydroxychloroquine (P=0.002, HR=0.09, 95% CI=0.02-0.32) was significantly associated with a decrease in the disease progression.
Conclusion: The advanced age and COVID-19 compatible thoracic computed tomography appearance were associated with progression of the disease, while hydroxychloroquine treatment was associated with decreased progression in mild COVID-19 patients.

Anahtar Kelimeler

2019 novel coronavirus disease, SARS-CoV-2 infection, COVID-19 pandemic, Disease progressions, Clinical deterioration

Destekleyen Kurum

yok

Proje Numarası

-

Teşekkür

-

Kaynakça

• 1. Timeline: WHO’s COVID-19 response [online]. Website https://www.who.int/emergencies/diseases/novel-coronavirus-2019/interactive-timeline [accessed 24 08 2020].
• 2. Khan G, Sheek-Hussein M, Al Suwaidi AR, Idris K, Abu-Zidan FM. Novel coronavirus pandemic: A global health threat. Turkish Jounal of Emergency Medicine. 2020 May 27;20(2):55-62. doi: 10.4103/2452-2473.285016.
• 3. Coronavirus Disease (COVID-19) Situation Reports [online]. Website https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports [accessed 24 08 2020].
• 4. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention [online]. Website https://www.cdc.gov/coronavirus/2019-ncov/hcp/ clinical-guidance-management-patients.html [accessed 24 08 2020].
• 5. Overview | COVID-19 rapid guideline: managing suspected or confirmed pneumonia in adults in the community | Guidance | NICE [online]. Website https://www.nice.org.uk/guidance/ng165 [accessed 24 08 2020].
• 6. Canada PHA of. Clinical Management of Patients with Moderate to Severe COVID-19 - Interim Guidance [online]. Website https://www.canada.ca/en/ public-health/services/diseases/2019-novel-coronavirus-infection/clinical-management-covid-19.html [accessed 24 08 2020].
• 7. HPS Website - COVID-19 - guidance for primary care [online]. Website https://www.hps.scot.nhs.uk/web-resources-container/covid-19-guidance-for-primary-care/ [accessed 24 08 2020].
• 8. Chinese Center for Disease Control and Prevention [online]. Website http://www.chinacdc.cn/en/COVID19/ [accessed 24 08 2020].
• 9. COVID-19 Algoritmalar [online]. Website https://covid19bilgi.saglik. gov.tr/tr/algoritmalar [accessed 24 08 2020].
• 10. Bartsch SM, Ferguson MC, McKinnell JA, O'Shea KJ, Wedlock PT et al. The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States: A simulation estimate of the direct medical costs and health care resource use associated with COVID-19 infections in the United States. Health Affairs (Millwood). 2020 Jun;39(6):927-935. doi: 10.1377/hlthaff.2020.00426.
• 11. Li X, Wang Y, Agostinis P, Rabson A, Melino G et al. Is hydroxychloroquine beneficial for COVID-19 patients? Cell Death & Disease. 2020 Jul 8;11(7):512. doi: 10.1038/s41419-020-2721-8.
• 12. Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM et al. A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19. New England Jounal of Medicine. 2020 Aug 6;383(6):517-525. doi: 10.1056/NEJMoa2016638.
• 13. Tang W, Cao Z, Han M, Wang Z, Chen J et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. The British Medical Journal. 2020 May 14;369:m1849. doi: 10.1136/bmj.m1849.
• 14. Mitjà O, Corbacho-Monné M, Ubals M, Tebe C, Peñafiel J et al. Hydroxychloroquine for Early Treatment of Adults with Mild Covid-19: A Randomized-Controlled Trial. Clinical Infectious Diseases. 2020 Jul 16;ciaa1009. doi: 10.1093/cid/ciaa1009.
• 15. Chen Z, Hu J, Zhang Z, S Jiang, S Han et al. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. MedRxiv 2020. doi: https://doi.org/10.1101/2020.03.22.20040758.
• 16. Siemieniuk RA, Bartoszko JJ, Ge L, Zeraatkar D, Izcovich A et al. Drug treatments for covid-19: living systematic review and network meta-analysis. The British Medical Journal. 2020 Jul 30;370:m2980. doi: 10.1136/bmj.m2980.
• 17. Asfahan S, Deokar K, Dutt N, Niwas R, Jain P et al. Extrapolation of mortality in COVID-19: Exploring the role of age, sex, co-morbidities and health-care related occupation. Monaldi Archives for Chest Disease. 2020 May 21;90(2). doi: 10.4081/monaldi.2020.1325.
• 18. Aksel G, Islam MM, Algin A, Eroğlu SE, Yaşar GB et al. et al. Early predictors of mortality for moderate to severely ill patients with Covid-19. American Journal of Emergency Medicine. 2020 Aug 28;S0735-6757(20)30770-1. doi: 10.1016/j.ajem.2020.08.076.
• 19. Polverino F. Cigarette Smoking and COVID-19: A Complex Interaction. American Journal of Respiratory and Critical Care Medicine. 2020 01;202(3):471–2. doi: 10.1164/rccm.202005-1646LE.
• 20. Hernández-Garduño E. Obesity is the comorbidity more strongly associated for Covid-19 in Mexico. A case-control study. Obesity Research & Clinical Practice. Jul-Aug 2020;14(4):375-379. doi: 10.1016/j.orcp.2020.06.001.
• 21. Kaur G, Lungarella G, Rahman I. SARS-CoV-2 COVID-19 susceptibility and lung inflammatory storm by smoking and vaping. Journal of Inflammation. 2020 Jun 10;17:21. doi: 10.1186/s12950-020-00250-8.