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Direct Comparison of Clinical Characteristics, Outcomes, and Risk Prediction in Patients with COVID-19 and Controls-A Prospective Cohort Study.
Lampart, Maurin; Rüegg, Marco; Jauslin, Andrea S; Simon, Noemi R; Zellweger, Núria; Eken, Ceylan; Tschudin-Sutter, Sarah; Bassetti, Stefano; Rentsch, Katharina M; Siegemund, Martin; Bingisser, Roland; Nickel, Christian H; Osswald, Stefan; Kuster, Gabriela M; Twerenbold, Raphael.
  • Lampart M; Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland.
  • Rüegg M; Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Jauslin AS; Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Simon NR; Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Zellweger N; Intensive Care Unit, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Eken C; Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland.
  • Tschudin-Sutter S; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Bassetti S; Division of Internal Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Rentsch KM; Laboratory Medicine, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Siegemund M; Intensive Care Unit, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Bingisser R; Department of Clinical Research, University of Basel, Petersplatz 1, 4001 Basel, Switzerland.
  • Nickel CH; Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Osswald S; Emergency Department, University Hospital Basel, Petersgraben 2, 4031 Basel, Switzerland.
  • Kuster GM; Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland.
  • Twerenbold R; Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Spitalstrasse 2, 4056 Basel, Switzerland.
J Clin Med ; 10(12)2021 06 17.
Article in English | MEDLINE | ID: covidwho-1273474
ABSTRACT
Most studies investigating early risk predictors in coronavirus disease 19 (COVID-19) lacked comparison with controls. We aimed to assess and directly compare outcomes and risk predictors at time of emergency department (ED) presentation in COVID-19 and controls. Consecutive patients presenting to the ED with suspected COVID-19 were prospectively enrolled. COVID-19-patients were compared with (i) patients tested negative (overall controls) and (ii) patients tested negative, who had a respiratory infection (respiratory controls). Primary outcome was the composite of intensive care unit (ICU) admission and death at 30 days. Among 1081 consecutive cases, 191 (18%) were tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 890 (82%) were tested negative (overall controls), of which 323 (30%) had a respiratory infection (respiratory controls). Incidence of the composite outcome was significantly higher in COVID-19 (23%) as compared with the overall control group (10%, adjusted-HR 2.45 (95%CI, 1.61-3.74), p < 0.001) or the respiratory control group (10%, adjusted-HR 2.93 (95%CI, 1.66-5.17), p < 0.001). Blood oxygen saturation, age, high-sensitivity troponin, c-reactive protein, and lactate dehydrogenase were identified as the strongest predictors of poor outcome available at time of ED presentation in COVID-19 with highly comparable prognostic utility in overall and respiratory controls. In conclusion, patients presenting to the ED with COVID-19 have a worse outcome than controls, even after adjustment for differences in baseline characteristics. Most predictors of poor outcome in COVID-19 were not restricted to COVID-19, but of comparable prognostic utility in controls and therefore generalizable to unselected patients with suspected COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10122672

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10122672