Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2

Background: In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world. Aim: To describe the clinical features, risk factors, and predictors of hospitalization in adult patients treated for acute respiratory infections associated with coronavirus SARS-CoV-2. Material and Methods: Descriptive prospective study of ambulatory and hospitalized adult patients with confirmed COVID-19 attended between April 1 and May 31, 2020. Clinical features, chronic comorbidities and demographic data were recorded, and patients were followed for two months as outpatients. Results: We assessed 1,022 adults aged 41 ± 14 years (50% men) with laboratory-confirmed COVID-19. One-third had comorbidities, specially hypertension (12.5%), hypothyroidism (6.6%), asthma (5.4%) and diabetes (4.5%). Hospital admission was required in 11%, 5.2% were admitted to critical care unit and 0.9% were connected to mechanical ventilation. Common symptoms included fatigue (55.4%), fever (52.5%), headache (68.6%), anosmia/dysgeusia (53.2%), dry cough (53.4%), dyspnea (27.4%) and diarrhea (35.5%). One third of patients reported persistence of symptoms at one-month follow-up, specially fatigue, cough and dyspnea. In the multivariate analysis, age, fever, cough, dyspnea and immunosuppression were associated with hospitalization and ICU admission. Age, male sex and moderate-severe dyspnea were associated with requirement of mechanical ventilation. The main predictors of prolonged clinical course were female sex, presence of comorbidities, history of dyspnea, cough, myalgia and abdominal pain. Conclusions: Clinical features of COVID-19 were highly unspecific. Prediction models for severity, will help medical decision making at the primary care setting.

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Main Authors: Saldías Peñafiel,Fernando, Peñaloza Tapia,Alejandro, Farías Nesvadba,Daniela, Farcas Oksenberg,Katia, Reyes Sánchez,Antonia, Cortés Meza,Josefina, Lara Hernández,Bárbara, Aguilera Fuenzalida,Pablo, Leiva Rodríguez,Isabel
Format: Digital revista
Language:Spanish / Castilian
Published: Sociedad Médica de Santiago 2020
Online Access:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001001387
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spelling oai:scielo:S0034-988720200010013872021-02-02Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2Saldías Peñafiel,FernandoPeñaloza Tapia,AlejandroFarías Nesvadba,DanielaFarcas Oksenberg,KatiaReyes Sánchez,AntoniaCortés Meza,JosefinaLara Hernández,BárbaraAguilera Fuenzalida,PabloLeiva Rodríguez,Isabel Coronavirus SARS-CoV-2 Diagnosis Prognosis Predictive Value of Tests Background: In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world. Aim: To describe the clinical features, risk factors, and predictors of hospitalization in adult patients treated for acute respiratory infections associated with coronavirus SARS-CoV-2. Material and Methods: Descriptive prospective study of ambulatory and hospitalized adult patients with confirmed COVID-19 attended between April 1 and May 31, 2020. Clinical features, chronic comorbidities and demographic data were recorded, and patients were followed for two months as outpatients. Results: We assessed 1,022 adults aged 41 ± 14 years (50% men) with laboratory-confirmed COVID-19. One-third had comorbidities, specially hypertension (12.5%), hypothyroidism (6.6%), asthma (5.4%) and diabetes (4.5%). Hospital admission was required in 11%, 5.2% were admitted to critical care unit and 0.9% were connected to mechanical ventilation. Common symptoms included fatigue (55.4%), fever (52.5%), headache (68.6%), anosmia/dysgeusia (53.2%), dry cough (53.4%), dyspnea (27.4%) and diarrhea (35.5%). One third of patients reported persistence of symptoms at one-month follow-up, specially fatigue, cough and dyspnea. In the multivariate analysis, age, fever, cough, dyspnea and immunosuppression were associated with hospitalization and ICU admission. Age, male sex and moderate-severe dyspnea were associated with requirement of mechanical ventilation. The main predictors of prolonged clinical course were female sex, presence of comorbidities, history of dyspnea, cough, myalgia and abdominal pain. Conclusions: Clinical features of COVID-19 were highly unspecific. Prediction models for severity, will help medical decision making at the primary care setting.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.148 n.10 20202020-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001001387es10.4067/S0034-98872020001001387
institution SCIELO
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country Chile
countrycode CL
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databasecode rev-scielo-cl
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region America del Sur
libraryname SciELO
language Spanish / Castilian
format Digital
author Saldías Peñafiel,Fernando
Peñaloza Tapia,Alejandro
Farías Nesvadba,Daniela
Farcas Oksenberg,Katia
Reyes Sánchez,Antonia
Cortés Meza,Josefina
Lara Hernández,Bárbara
Aguilera Fuenzalida,Pablo
Leiva Rodríguez,Isabel
spellingShingle Saldías Peñafiel,Fernando
Peñaloza Tapia,Alejandro
Farías Nesvadba,Daniela
Farcas Oksenberg,Katia
Reyes Sánchez,Antonia
Cortés Meza,Josefina
Lara Hernández,Bárbara
Aguilera Fuenzalida,Pablo
Leiva Rodríguez,Isabel
Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2
author_facet Saldías Peñafiel,Fernando
Peñaloza Tapia,Alejandro
Farías Nesvadba,Daniela
Farcas Oksenberg,Katia
Reyes Sánchez,Antonia
Cortés Meza,Josefina
Lara Hernández,Bárbara
Aguilera Fuenzalida,Pablo
Leiva Rodríguez,Isabel
author_sort Saldías Peñafiel,Fernando
title Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2
title_short Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2
title_full Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2
title_fullStr Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2
title_full_unstemmed Manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus SARS-CoV-2
title_sort manifestaciones clínicas y predictores de gravedad en pacientes adultos con infección respiratoria aguda por coronavirus sars-cov-2
description Background: In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world. Aim: To describe the clinical features, risk factors, and predictors of hospitalization in adult patients treated for acute respiratory infections associated with coronavirus SARS-CoV-2. Material and Methods: Descriptive prospective study of ambulatory and hospitalized adult patients with confirmed COVID-19 attended between April 1 and May 31, 2020. Clinical features, chronic comorbidities and demographic data were recorded, and patients were followed for two months as outpatients. Results: We assessed 1,022 adults aged 41 ± 14 years (50% men) with laboratory-confirmed COVID-19. One-third had comorbidities, specially hypertension (12.5%), hypothyroidism (6.6%), asthma (5.4%) and diabetes (4.5%). Hospital admission was required in 11%, 5.2% were admitted to critical care unit and 0.9% were connected to mechanical ventilation. Common symptoms included fatigue (55.4%), fever (52.5%), headache (68.6%), anosmia/dysgeusia (53.2%), dry cough (53.4%), dyspnea (27.4%) and diarrhea (35.5%). One third of patients reported persistence of symptoms at one-month follow-up, specially fatigue, cough and dyspnea. In the multivariate analysis, age, fever, cough, dyspnea and immunosuppression were associated with hospitalization and ICU admission. Age, male sex and moderate-severe dyspnea were associated with requirement of mechanical ventilation. The main predictors of prolonged clinical course were female sex, presence of comorbidities, history of dyspnea, cough, myalgia and abdominal pain. Conclusions: Clinical features of COVID-19 were highly unspecific. Prediction models for severity, will help medical decision making at the primary care setting.
publisher Sociedad Médica de Santiago
publishDate 2020
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872020001001387
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