The Clinical Course of COVID-19 in the Outpatient Setting: A Prospective Cohort Study
| Autor: | Blair, Paul W, Brown, Diane M, Jang, Minyoung, Antar, Annukka A R, Keruly, Jeanne C, Bachu, Vismaya S, Townsend, Jennifer L, Tornheim, Jeffrey A, Keller, Sara C, Sauer, Lauren, Thomas, David L, Manabe, Yukari C, Cox, Andrea L, Heaney, Chris D, Klein, Sabra L, Mehta, Shruti H, Mostafa, Heba, Pekosz, Andy S, Pisanic, Nora, Smith, L Leigh, Armstrong, Derek T, Azamfirei, Razvan, Barnaba, Brittany, Charles, Curtisha, Church, Taylor, Dai, Weiwei, Fuchs, Joelle, Ganesan, Abhinaya, Hardick, Justin, Holden, Jeffrey, Johnstone, Jaylynn R, Kruczynski, Kate, Kusemiju, Oyinkansola, Lambrou, Anastasia, Li, Lucy, Littlefield, Kirsten, Montana, Manuela Plazas, Park, Han-Sol, Payton, Christine B, Popper, Caroline, Prizzi, Michelle, Reuland, Carolyn J, Sewell, Thelio, Tuchler, Amanda, Ursin, Rebecca L, Walch, Samantha N |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Population Vital signs Disease recovery of function Logistic regression 01 natural sciences Major Articles 03 medical and health sciences 0302 clinical medicine Ambulatory care ambulatory care Interquartile range Internal medicine middle aged Sore throat medicine 030212 general & internal medicine 0101 mathematics education Prospective cohort study education.field_of_study business.industry coronavirus infections/epidemiology 010102 general mathematics Emergency department medicine.disease Comorbidity Confidence interval Infectious Diseases AcademicSubjects/MED00290 Oncology Cohort treatment outcome Chills medicine.symptom business |
| Zdroj: | Open Forum Infectious Diseases |
| ISSN: | 2328-8957 |
| Popis: | BackgroundOutpatient COVID-19 has been insufficiently characterized.ObjectiveTo determine the progression of disease and subsequent determinants of hospitalization.DesignA prospective outpatient cohort.SettingOutpatients were recruited by phone between April 21 to June 23, 2020 after receiving outpatient or emergency department testing within a large health network in Maryland, USA.ParticipantsOutpatient adults with positive RT-PCR results for SARS-CoV-2.MeasurementsSymptoms, portable pulse oximeter oxygen saturation (SaO2), heart rate, and temperature were collected by participants on days 0, 3, 7, 14, 21, and 28 after enrollment. Baseline demographics, comorbid conditions were evaluated for risk of subsequent hospitalization using negative binomial, logistic, and random effects logistic regression.ResultsAmong 118 SARS-CoV-2 infected outpatients, the median age was 56.0 years (IQR, 50.0 to 63.0) and 50 (42.4%) were male. Among those reporting active symptoms, the most common symptoms during the first week since symptom onset included weakness/fatigue (67.3%), cough (58.0%), headache (43.8%), and sore throat (34.8%). Participants returned to their usual health a median of 20 days (IQR, 13 to 38) from the symptom onset, and only 65.5% of respondents were at their usual health during the fourth week of illness. Over 28 days, 10.9% presented to the emergency department and 7.6% required hospitalization. Individuals at the same duration of illness had a 6.1 times increased adjusted odds of subsequent hospitalization per every percent decrease in home SaO2(95% confidence interval [CI]: 1.41 to 31.23, p=0.02).LimitationsSeverity and duration of illness may differ in a younger population.ConclusionSymptoms often persisted but uncommonly progressed to hospitalization. Home SaO2might be an important adjunctive tool to identify progression of COVID-19.RegistrationClinicaltrials.gov NCT number:NCT04496466Funding SourceThe Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases Discovery Program and the Johns Hopkins University School of Medicine |
| Databáze: | OpenAIRE |
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