Comparison of clinical characteristics and outcome measures of PCR-positive and PCR-negative patients diagnosed as COVID-19: Analyses focusing on the older adults.

PURPOSE: While the definitive diagnosis of COVID-19 relies on PCR confirmation of the virus, the sensitivity of this technique is limited. The clinicians had to go on with the clinical diagnosis of COVID-19 in selected cases. We aimed to compare PCR-positive and PCR-negative patients diagnosed as COVID-19 with a specific focus on older adults. METHODS: We studied 601 hospitalized adults. The demographics, co-morbidities, triage clinical, laboratory characteristics, and outcomes were noted. Differences between the PCR (+) and (-) cases were analyzed. An additional specific analysis focusing on older adults (≥65 years) (n = 184) was performed. RESULTS: The PCR confirmation was present in 359 (59.7 %). There was not any difference in terms of age, sex, travel/contact history, hospitalization duration, ICU need, the time between first symptom/hospitalization to ICU need, ICU days, or survival between PCR-positive and negative cases in the total study group and older adults subgroup. The only symptoms that were different in prevalence between PCR-confirmed and unconfirmed cases were fever (73.3 % vs. 64 %, p = 0.02) and fatigue/myalgia (91.1 % vs. 79.3 %, p = 0.001). Bilateral diffuse pneumonia was also more prevalent in PCR-confirmed cases (20 % vs. 13.3 %, p = 0.03). In older adults, the PCR (-) cases had more prevalent dyspnea (72.2 % vs. 51.4 %, p = 0.004), less prevalent fatigue/myalgia (70.9 % vs. 88.6 %, p = 0.002). CONCLUSION: The PCR (+) and (-) cases displayed very similar disease phenotypes, courses, and outcomes with few differences between each other. The presence of some worse laboratory findings may indicate a worse immune protective response in PCR (-) cases.

PATIENT CHARACTERISTICS AND RISK FACTORS FOR MORTALITY IN 504 HOSPITALIZED PATIENTS DUE TO COVID-19

Objective: In this study, we aimed to analyze the demographic characteristics, symptoms, and comorbidities of 504 patients hospitalized for COVID-19. We also sought to describe the relationship between these features and intensive care unit (ICU) admission and mortality. Materials and Methods: This study is a descriptive study involving 504 COVID-19 patients hospitalized between 16.03.2020 and 07.05.2020 at Istanbul Universitys’ Istanbul Faculty of Medicine Hospital. Information about the patients was obtained from the hospital automation system and evaluated retrospectively. Results: The average age of the 504 patients was 56±15.14, and 59.1% of them were male. The proportion of the patients admitted into ICU 11.9% and for 8.52% of them the disease resulted in death. Real time polymerase chain reaction (RT-PCR) test results were positive for 60.5% of the patients. The median time spent in the hospital was eight days. Fifty six percent of the patients had at least one accompanying comorbid disease, with hypertension (39.3%) and diabetes (20.8%) being the most common. Being 65 years old or older (p<0.001), days spent in the hospital (p<0.001), presence of at least one comorbidity (p=0.009), hypertension (p=0.003), coronary artery disease (p=0.004), congestive heart failure (p=0.005) and dyspnea (p<0.001) were all factors found in those admitted to ICU. Conclusion: COVID-19 infection leading to high morbidity-mortality rates and an increased requirement for ICU admission is mainly seen among older patients and those who have dyspnea. During the process of analyzing patients suspected of COVID-19 who are admitted to hospital, it is crucial to consider both the patient’s age and any respiratory symptoms. Such a clinical evaluation is crucial for a better understanding of the course of the disease. (English) [ FROM AUTHOR] Amaç: Bu araştırmada, COVID-19 nedeniyle tedavi almak üzere hastaneye yatırılan 504 hastanın demografik özellikleri, semptomları ve komorbiditeleri incelenerek;bu özelliklerin yoğun bakım ünitesine yatış ve mortalite ile ilişkisini ortaya koymak amaçlanmıştır. Gereç ve Yöntem: Bu araştırma, 16.03.2020-07.05.2020 tarihleri arasında COVID-19 tedavisi almak üzere Ístanbul Üniversitesi Ístanbul Tıp Fakültesi Hastanesi’ne yatırılan 504 hastanın dahil edildiği tanımlayıcı tipte bir araştırmadır. Hastalara ait bilgiler hastane otomasyon sisteminden alınarak retrospektif olarak değerlendirilmiştir. Bulgular: Beşyüz dört hastanın yaş ortalaması 56±15,14 yıl, hastaların %59,1’i erkekti. Yoğun bakım ünitesine yatışı olan hastaların oranı %11,9;ölen hastaların oranı %8,52 idi. Hastaların %60,5’inin test sonucu pozitifti. Hastanede kalınan sürenin ortancası sekiz gündü. Hastaların %56’sının en az bir komorbid hastalığı vardı;hipertansiyon (%39,3) ve diyabet (%20,8) en sık eşlik eden komorbiditelerdi. Altmış beş yaş ve üzeri olmak (p<0,001), hastanede kalınan gün sayısı (p<0,001), en az bir komorbidite varlığı (p=0,009), hipertansiyon (p=0,003), koroner arter hastalığı (p=0,004), konjestif kalp yetmezliği (p=0,005) ve dispne (p<0,001), yoğun bakıma yatış ile ilişkili bulunmuştur. Sonuç: Yüksek morbidite-mortalite oranlarına ve yoğun bakım ünitesine yatış ihtiyacının artmasına neden COVID-19, özellikle yaşlı hastalarda ve dispnesi olan hastalarda daha yüksek mortalite oranlarına neden olmaktadır. Hastaneye başvuran COVID-19 şüpheli hastalar değerlendirilirken özellikle hastanın yaşı ve solunum sistemi semptomları göz önünde bulundurularak klinik değerlendirilmesinin yapılması hastalığın seyri açısından önem taşımaktadır. (Turkish) [ FROM AUTHOR] Copyright of Istanbul Tip Fakültesi Dergisi is the property of Istanbul Tip Fakultesi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)