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Clinical features, diagnostics, and outcomes of patients presenting with acute respiratory illness: A retrospective cohort study of patients with and without COVID-19.
Shah, Sachin J; Barish, Peter N; Prasad, Priya A; Kistler, Amy; Neff, Norma; Kamm, Jack; Li, Lucy M; Chiu, Charles Y; Babik, Jennifer M; Fang, Margaret C; Abe-Jones, Yumiko; Alipanah, Narges; Alvarez, Francisco N; Botvinnik, Olga Borisovna; Castaneda, Gloria; Dadasovich, Rand M; Davis, Jennifer; Deng, Xianding; DeRisi, Joseph L; Detweiler, Angela M; Federman, Scot; Haliburton, John; Hao, Samantha; Kerkhoff, Andrew D; Kumar, G Renuka; Malcolm, Katherine B; Mann, Sabrina A; Martinez, Sandra; Mary, Rupa K; Mick, Eran; Mwakibete, Lusajo; Najafi, Nader; Peluso, Michael J; Phelps, Maira; Pisco, Angela Oliveira; Ratnasiri, Kalani; Rubio, Luis A; Sellas, Anna; Sherwood, Kyla D; Sheu, Jonathan; Spottiswoode, Natasha; Tan, Michelle; Yu, Guixia; Kangelaris, Kirsten Neudoerffer; Langelier, Charles.
  • Shah SJ; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Barish PN; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Prasad PA; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Kistler A; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Neff N; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Kamm J; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Li LM; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Chiu CY; Division of Infectious Diseases, University of California, San Francisco, CA, USA.
  • Babik JM; Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
  • Fang MC; Division of Infectious Diseases, University of California, San Francisco, CA, USA.
  • Abe-Jones Y; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Alipanah N; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Alvarez FN; Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA, USA.
  • Botvinnik OB; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Castaneda G; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Davis J; Department of Medicine, University of California, San Francisco, CA, USA.
  • Deng X; Department of Medicine, University of California, San Francisco, CA, USA.
  • DeRisi JL; Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
  • Detweiler AM; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Federman S; Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA.
  • Haliburton J; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Hao S; Department of Laboratory Medicine, University of California, San Francisco, CA, USA.
  • Kerkhoff AD; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Kumar GR; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Malcolm KB; Division of Infectious Diseases, University of California, San Francisco, CA, USA.
  • Mann SA; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Martinez S; Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA, USA.
  • Mary RK; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Mick E; Department of Biochemistry and Biophysics, University of California, San Francisco, CA, USA.
  • Mwakibete L; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Najafi N; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Peluso MJ; Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, CA, USA.
  • Phelps M; Division of Infectious Diseases, University of California, San Francisco, CA, USA.
  • Pisco AO; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Ratnasiri K; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Rubio LA; Division of Hospital Medicine, University of California, San Francisco, CA, USA.
  • Sellas A; Division of Infectious Diseases, University of California, San Francisco, CA, USA.
  • Sherwood KD; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Sheu J; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Spottiswoode N; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Tan M; Program in Immunology, Stanford University School of Medicine, Stanford, CA, 94305, USA.
  • Yu G; Division of Infectious Diseases, University of California, San Francisco, CA, USA.
  • Kangelaris KN; Chan Zuckerberg Biohub, San Francisco, CA, USA.
  • Langelier C; Vitalant Research Institute, San Francisco, CA, USA.
EClinicalMedicine ; 27: 100518, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-730421
ABSTRACT

BACKGROUND:

Most data on the clinical presentation, diagnostics, and outcomes of patients with COVID-19 have been presented as case series without comparison to patients with other acute respiratory illnesses.

METHODS:

We examined emergency department patients between February 3 and March 31, 2020 with an acute respiratory illness who were tested for SARS-CoV-2. We determined COVID-19 status by PCR and metagenomic next generation sequencing (mNGS). We compared clinical presentation, diagnostics, treatment, and outcomes.

FINDINGS:

Among 316 patients, 33 tested positive for SARS-CoV-2; 31 without COVID-19 tested positive for another respiratory virus. Among patients with additional viral testing (27/33), no SARS-CoV-2 co-infections were identified. Compared to those who tested negative, patients with COVID-19 reported longer symptoms duration (median 7d vs. 3d, p < 0.001). Patients with COVID-19 were more often hospitalized (79% vs. 56%, p = 0.014). When hospitalized, patients with COVID-19 had longer hospitalizations (median 10.7d vs. 4.7d, p < 0.001) and more often developed ARDS (23% vs. 3%, p < 0.001). Most comorbidities, medications, symptoms, vital signs, laboratories, treatments, and outcomes did not differ by COVID-19 status.

INTERPRETATION:

While we found differences in clinical features of COVID-19 compared to other acute respiratory illnesses, there was significant overlap in presentation and comorbidities. Patients with COVID-19 were more likely to be admitted to the hospital, have longer hospitalizations and develop ARDS, and were unlikely to have co-existent viral infections.

FUNDING:

National Center for Advancing Translational Sciences, National Heart Lung Blood Institute, National Institute of Allergy and Infectious Diseases, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100518

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Language: English Journal: EClinicalMedicine Year: 2020 Document Type: Article Affiliation country: J.eclinm.2020.100518