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.

Content Provider	Europe PMC
Author	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
Abstract	PurposeAdequate 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.MethodsA cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed.ResultsForty-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.ConclusionsOur 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.Supplementary InformationThe online version contains supplementary material available at 10.1007/s15010-021-01594-w.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8061715&blobtype=pdf
ISSN	03008126
Journal	Infection
Volume Number	49
DOI	10.1007/s15010-021-01594-w
PubMed Central reference number	PMC8061715
Issue Number	4
PubMed reference number	33890243
e-ISSN	14390973
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2021-04-22
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2021
Subject Keyword	Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Coronavirus disease 2019 (COVID-19) Viral concentration COVID-19 nucleic acid testing Respiratory distress syndrome Mechanical ventilation Artificial respiration Prospective study Symptom assessment
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Microbiology (medical)