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

Abstract

Background:In December 2019, coronavirus disease 2019 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.

Pathophysiology of Acute Respiratory Failure by CoV-2 Infection: Role of Oxidative Stress, Endothelial Dysfunction and Obesity

“…From the ventilatory point of view, the patients need high positive end-expiratory pressure and respond well to recruitment maneuvers. This ventilatory pattern has been associated with a higher obesity in our clinical cohort and high cardiopulmonary comorbidities (hypertensive disease and chronic obstructive pulmonary disease) [18].…”

A multicenter study of confirmed COVID-19 cases: preliminary data on 2690 pediatric patients in Argentina during the first year of the pandemic

“…17 Based on these considerations, it may be said that pediatric hospitalization due to COVID-19 in 2020 was not necessarily associated with disease severity, as in the case of adults. 18,19 At this point, it is worth noting as a limitation of this study that some sites only included hospitalized cases and that epidemiological criteria for hospitalization varied among jurisdictions.…”

Estudio multicéntrico de casos confirmados de COVID-19: datos preliminares de 2690 pacientes pediátricos en Argentina durante el primer año de la pandemia

“…17 De acuerdo a estas consideraciones, se puede afirmar que la internación pediátrica por COVID-19 en el año 2020 no respondió necesariamente a un criterio de gravedad de la enfermedad, como sí lo fue en adultos. 18,19 En este punto, se señala como limitación de este estudio que algunos centros solo incluyeron los casos hospitalizados y que los criterios epidemiológicos de internación difirieron entre las jurisdicciones.…”