Abstract
There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for coronavirus disease 2019 (COVID-19). In this observational study, we aimed to describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior to hospitalization. Forty-eight patients (27 non-ICU and 21 ICU) with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were analyzed (mean age, 66 years, [range, 33–88 years]; 67% males). There were no differences in age or sex among groups. Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs. 61%, p = 0.022). ICU-patients had lymphopenia as well as hypoalbuminemia. Lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < 0.001). Lower albumin levels were associated with poor prognosis measured as longer hospital length (r = −0.472, p < 0.001) and mortality (r = −0.424, p = 0.003). As of 28 April 2020, 10 patients (8 ICU and 2 non-ICU) have died (21% mortality), and while 100% of the non-ICU patients have been discharged, 33% of the ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward). Critically ill patients with COVID-19 present lymphopenia, hypoalbuminemia and high levels of inflammation.
Highlights
The SARS-CoV-2 outbreak first identified in Wuhan in December 2019 has rapidly spread worldwide [1]
Efforts are being made in order to fully characterize the clinical characteristics of COVID-19 nationwide
The patients were classified as non-intensive care unit (ICU) and ICU according to the severity and the guidelines of the Son Llatzer University Hospital for COVID-19 management
Summary
The SARS-CoV-2 outbreak first identified in Wuhan in December 2019 has rapidly spread worldwide [1]. It is imperative to clinically characterize critically ill COVID-19 patients in order to identify those with a bad prognosis at an early stage, before their situation becomes irreversible. It has been proposed that a hyperinflammatory syndrome may play a central role in the progression from mild to severe or critical COVID-19 [6,7,8,9,10]. Judging from similar hyperinflammatory syndromes like bacterial sepsis, fluctuations of these biomarkers will probably be strongly interrelated and time dependent [13]. Until this process is fully characterized, biochemical parameters and physical examinations are the only tools available for tracking disease progression. Efforts are being made in order to fully characterize the clinical characteristics of COVID-19 nationwide. The objective of this retrospective case series study was to describe the epidemiological and clinical characteristics of 48 hospitalized patients with COVID-19 and to compare patients who were admitted to the intensive care unit (ICU) care with those who did not receive ICU care, staying at a ward
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