to describe clinical characteristics (risk factors and outcomes) of vaccine-naive COVID-19 patients
to document comparative surveillance data to assist(aide) decisions about pandemic control strategies
Upon Turkish MoH and local ethical approval, EPR of COVID-19 patients hospitalized in 3 pandemic hospitals (March 11th-May 30th,2020) were descriptively screened. After excluding 44 records (uneligible/missing data) a total of 298 patient records were included. Data are presented as mean+/-SD and %.
Baseline patient characteristics were:age 52.4+/-16.6 years, 63% male, pulse 84+/-13/minute, BP 128+/-16/74+/-11mmHg, respiratory rate 21+/-11/minute, capillary oxygene saturation 97+/-2%, body temperature 37+/-1Celsius, BMI 28+/-6.kg/m2,>=1 chronic condition 47%, multimorbid 25%, ASCVD 33,3%, Hypertension 30,4%, Diabetes 28,4%, polypharmacy 16%, COVID-19 close contact 26%, good general condition 91,3%, symptomatic 97%,fever 71%->38C 10%,dry cough 64,4%,fatigue 46%,dyspnoe 22,1%,myalgia 19%,sore throat 8%,capillary oxygene saturation(<95%) 8%.All patients (n=298) underwent PCR, 98% (n=283)had a CT scan, pneumonia was diagnosed in 98.3% (n=258), 88% (n=254) were confirmed as COVID-19 pneumonia, whereas, PCR test positivity rate was 55% (n=158).
Median hospital duration was 6 days (range 1-69),rehospitalization due to COVID-19 (n=8)2,8%, ICU treatment 11,8% (n=34), intubation 8,3% (n=24, constituting 70,6% of all ICU treated patients), median ICU duration was 10,5 days(range 1-65)with 11,5 days (range 1-66) median intubation duration. Mortality rate was 3,8% (n=11), all patients who died were treated in the ICU and 10 out of 11 fatalities were intubated.Nearly all patients who died had diabetes (OR 28.5, 95% CI 3.6 to 226.3, p<0.001) and mortality was 10 times more common (81,8% vs. 18.2%) among patients with ASCVD (OR 9.8, 95% CI 2.1 to 46.4, p=0.001).
Results of this study with its risk profile and outcomes are similar to publications from early 2022.However, impact of important developments like vaccination and mutations on the course of the pandemic can be evaluated by comparing present data with such historical vaccine-naive patient population data.
Points for discussion:
Have COVID-19 clinical features changed, how?
What is the function-value of such "historical control" data for evaluation the course of a pandemic?