First results of the "Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS)"

Abstract

Purpose: Knowledge regarding patients' clinical condition at severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection is sparse. Data in the international, multicenter Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort study may enhance the understanding of COVID-19.

Methods: Sociodemographic and clinical characteristics of SARS-CoV-2-infected patients, enrolled in the LEOSS cohort study between March 16, 2020, and May 14, 2020, were analyzed. Associations between baseline characteristics and clinical stages at diagnosis (uncomplicated vs. complicated) were assessed using logistic regression models.

Results: We included 2155 patients, 59.7% (1,287/2,155) were male; the most common age category was 66-85 years (39.6%; 500/2,155). The primary COVID-19 diagnosis was made in 35.0% (755/2,155) during complicated clinical stages. A significant univariate association between age; sex; body mass index; smoking; diabetes; cardiovascular, pulmonary, neurological, and kidney diseases; ACE inhibitor therapy; statin intake and an increased risk for complicated clinical stages of COVID-19 at diagnosis was found. Multivariable analysis revealed that advanced age [46-65 years: adjusted odds ratio (aOR): 1.73, 95% CI 1.25-2.42, p = 0.001; 66-85 years: aOR 1.93, 95% CI 1.36-2.74, p < 0.001; > 85 years: aOR 2.38, 95% CI 1.49-3.81, p < 0.001 vs. individuals aged 26-45 years], male sex (aOR 1.23, 95% CI 1.01-1.50, p = 0.040), cardiovascular disease (aOR 1.37, 95% CI 1.09-1.72, p = 0.007), and diabetes (aOR 1.33, 95% CI 1.04-1.69, p = 0.023) were associated with complicated stages of COVID-19 at diagnosis.

Conclusion: The LEOSS cohort identified age, cardiovascular disease, diabetes and male sex as risk factors for complicated disease stages at SARS-CoV-2 diagnosis, thus confirming previous data. Further data regarding outcomes of the natural course of COVID-19 and the influence of treatment are required.

Keywords: COVID-19; Cohort study; LEOSS; SARS-CoV-2.

Fig. 1

Top—definition of uncomplicated and complicated clinical stage. The respective stage is considered to be present if one of the criteria is met. Bottom—parameters included into Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS). Sub-questionnaires under development at the time of submission of this manuscript are defined with asterisk (*). paO2 partial pressure of oxygen, SaO2 oxygen saturation, AST aspartate aminotransferase, ALT alanine transaminase, ULN upper limit of normal in the respective local laboratory, qSOFA quick sequential [sepsis-related] organ failure assessment

Fig. 2

Age–gender distribution and clinical stage at time of SARS-CoV-2 detection. The bars are divided according to the clinical condition at time of SARS-CoV-2 detection (uncomplicated vs. complicated). The number of individuals in the total population is 2155

Fig. 3

Clinical–chemical laboratory parameters and vital parameters at the time of SARS-CoV-2 detection. Relative proportions to the measured/collected parameters are shown (missing values were excluded). The colors (green to red) express an increase in impairment from the normal to slightly impaired range (green) to critically impaired (red). Normal values are CRP < 5 mg/l; ferritin male < 300, females < 150 µg/l; PCT < 0.5 ng/l; IL6 < 10 pg/ml; oxygen saturation 96–100%; oxygen partial pressure ≥ 80 mmHg; carbon dioxide partial pressure 35–45 mmHg; temperature < 37.3 °C; respiratory rate < 16 per min. CRP C-reactive protein, PCT procalcitonin, IL6 interleukin-6, LDH lactate dehydrogenase, ALT alanine aminotransferase, AST aspartate aminotransferase, Gamma-GT gamma-glutamyl transferase, ULN upper limit of normal in the respective local laboratory. The number of individuals in the total population is 2155