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. 2020 Dec;81(6):937-943.
doi: 10.1016/j.jinf.2020.09.033. Epub 2020 Sep 28.

Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: A comparison of patients with and without SARS-CoV-2 infection

Nathan J Brendish  1 , Stephen Poole  2 , Vasanth V Naidu  3 , Christopher T Mansbridge  3 , Nicholas Norton  3 , Florina Borca  4 , Hang Tt Phan  4 , Helen Wheeler  5 , Matthew Harvey  5 , Laura Presland  5 , Tristan W Clark  6
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Clinical characteristics, symptoms and outcomes of 1054 adults presenting to hospital with suspected COVID-19: A comparison of patients with and without SARS-CoV-2 infection

Nathan J Brendish et al. J Infect. 2020 Dec.

Abstract

Objectives: Most reports describing the characteristics of patients hospitalised with COVID-19 lack a comparator group. We compared clinical characteristics, symptoms, and outcomes of adults presenting to hospital during the pandemic first wave, who tested positive and negative for SARS-CoV-2.

Methods: Detailed patient data was obtained from a large, controlled, non-randomised trial of molecular point-of-care testing versus laboratory RT-PCR for SARS-CoV-2 in adults presenting to a large UK hospital with suspected COVID-19.

Results: 1054 patients were included: 352 (33.4%) tested positive and 702 (66.6%) negative. 13.4% (47/352) COVID-19-positive patients had COPD versus 18.7% (131/702) of COVID-19-negative patients (difference=5.3% [95%CI -9.7% to -0.5%], p = 0.0297). 5.7% (20/352) of COVID-19-positive patients were smokers versus 16.5% (116/702) of negative patients (difference=-10.8% [-14.4% to -7.0%], p = 0.0001). 70.5% (248/352) of COVID-19-positive patients were White-British versus 85.5% (600/702) of negative patients (difference=-15.0% [-20.5% to -9.7%], p<0.0001). 20.9% (39/187) of COVID-19-positive patients were healthcare workers versus 5.2% (15/287) of negative patients (p<0.0001). Anosmia was reported in 33.1% (47/142) versus 8.8% (19/216) of COVID-19-positive and negative patients respectively (p<0.0001). Non-SARS-CoV-2 respiratory viruses or atypical bacteria were detected in 2.5% (5/197) of COVID-19 patients versus 7.9% (24/302) of COVID-19-negative patients (p = 0.0109). Hospitalisation duration and 30-day-mortality were higher in COVID-19 patients and invasive ventilation was more frequent (11.1% vs 2.8%, p<0.0001), and longer (14.5 vs 4.7 days, p = 0.0015).

Conclusions: There were substantial differences between patients with and without COVID-19 in terms of ethnicity, healthcare worker-status, comorbidities, symptoms, and outcomes. These data can inform healthcare planning for the next phase of the pandemic.

Keywords: COPD; COVID-19; Clinical characteristics; Cohort; Healthcare workers; Outcomes; SARS-CoV-2; Smokers; Symptoms.

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Conflict of interest statement

Declaration of Competing Interest TWC reports non-financial support from QIAGEN in the form of discounted equipment and consumables for this work. He also reports personal fees from BioMerieux and BioFire LLC, non-financial support from BioMerieux and BioFire LLC, personal fees from Synairgen Research Ltd, Roche, Cidara therapeutics, Janssen, Planet Innovation and Randox diagnostics, and grants from NIHR, all outside this work. Other authors report no conflicts of interest.

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