Abstract

BackgroundThis study aims to describe the epidemiology of COVID-19 patients in a Swiss university hospital.MethodsThis retrospective observational study included all adult patients hospitalized with a laboratory confirmed SARS-CoV-2 infection from March 1 to March 25, 2020. We extracted data from electronic health records. The primary outcome was the need to mechanical ventilation at day 14. We used multivariate logistic regression to identify risk factors for mechanical ventilation. Follow-up was of at least 14 days.Results145 patients were included in the multivariate model, of whom 36 (24.8%) needed mechanical ventilation at 14 days. The median time from symptoms onset to mechanical ventilation was 9·5 days (IQR 7.00, 12.75). Multivariable regression showed increased odds of mechanical ventilation with age (OR 1.09 per year, 95% CI 1.03–1.16, p = 0.002), in males (OR 6.99, 95% CI 1.68–29.03, p = 0.007), in patients who presented with a qSOFA score ≥2 (OR 7.24, 95% CI 1.64–32.03, p = 0.009), with bilateral infiltrate (OR 18.92, 3.94–98.23, p<0.001) or with a CRP of 40 mg/l or greater (OR 5.44, 1.18–25.25; p = 0.030) on admission. Patients with more than seven days of symptoms on admission had decreased odds of mechanical ventilation (0.087, 95% CI 0.02–0.38, p = 0.001).ConclusionsThis study gives some insight in the epidemiology and clinical course of patients admitted in a European tertiary hospital with SARS-CoV-2 infection. Age, male sex, high qSOFA score, CRP of 40 mg/l or greater and a bilateral radiological infiltrate could help clinicians identify patients at high risk for mechanical ventilation.

Highlights

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first emerged in Wuhan (China) in December 2019

  • Patients with more than seven days of symptoms on admission had decreased odds of mechanical ventilation (0.087, 95% CI 0.02–0.38, p = 0.001)

  • This study gives some insight in the epidemiology and clinical course of patients admitted in a European tertiary hospital with SARS-CoV-2 infection

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Summary

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first emerged in Wuhan (China) in December 2019. There is a wide spectrum of severity ranging from asymptomatic presentation to severe pneumonia requiring ventilator support and death [2]. Since March 2020, the pace of SARS-CoV-2 spread around the globe increased as the epidemic evolved to a pandemic [3]. In Europe, following a diminished caseload during summer 2020, new cases and deaths are increasing since September 2020 [4]. We report the epidemiological and clinical characteristics of patients hospitalized for COVID-19 in a Swiss university hospital during the early phase of the pandemic as well as risk factors for progressive respiratory failure requiring mechanical ventilation. This study aims to describe the epidemiology of COVID-19 patients in a Swiss university hospital

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