Abstract

To describe epidemiological and clinical features of patients confirmed as having SARS-CoV-2 infection and managed in isolation at home. We performed a multicenter retrospective study enrolling all SARS-CoV-2-positive adults evaluated from 28 February to 31 May 2020 at one of nine COVID-19 Units in southern Italy: we included patients receiving care at home and those admitted to hospital. We defined patients with not-severe disease if they were asymptomatic or experienced a mild infection that did not need oxygen (O2) therapy and those with a severe infection if hospitalized and required O2 therapy. We enrolled 415 patients with SARS-CoV-2 infection: 77 were managed in isolation at home, 338 required hospital management. The 77 patients in home isolation were less frequently male than hospitalized patients (55% vs. 64%; <0.01) and were younger (median age 45 years (IQR:19) vs. 62 (IQR 22); p < 0.01), had a lower Charlson comorbidity index (median 0 (IQR2) vs. 6 (IQR 3); p < 0.01), and included fewer subjects with an underlying chronic disease (36% vs. 59%; p < 0.01). According to a binomial logistic regression analysis, a younger age (OR: 0.96 (95% IC: 0.94–0.98), p < 0.01) and a low Charlson comorbidity index (OR: 0.66 (95% IC: 0.54–0.83); p < 0.01) were independent factors associated with at-home management. The identification of subjects with SARS-CoV-2 infection who could be managed in home isolation is useful in clinical practice. A younger age and no comorbidities were identified as factors independently associated with home management.

Highlights

  • IntroductionSince December 2019, a new zoonotic beta-corona virus, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread all over the world, causing a disease known as Coronavirus disease-19 (Covid-19) [1,2,3]

  • Since December 2019, a new zoonotic beta-corona virus, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread all over the world, causing a disease known as Coronavirus disease-19 (Covid-19) [1,2,3].This infection is transmitted from human-to-human through nasal or oral droplets or through close contact; fecal–oral transmission has a modest epidemiologic impact [2,4,5,6]

  • The present study evaluated the demographic and clinical features of SARS-CoV-2 infection in 77 patients in home isolation in southern Italy, with, as a term of comparison, the patients hospitalized in nine COVID 19 units

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Summary

Introduction

Since December 2019, a new zoonotic beta-corona virus, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread all over the world, causing a disease known as Coronavirus disease-19 (Covid-19) [1,2,3]. This infection is transmitted from human-to-human through nasal or oral droplets or through close contact; fecal–oral transmission has a modest epidemiologic impact [2,4,5,6]. Little data are available in the literature on the clinical features characteristic of patients who could be managed at home, so clinical criteria and biomarkers are needed to help differentiate between individuals more likely to progress to a severe illness

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