Characteristics, predictors and outcomes among 99 patients hospitalised with COVID-19 in a tertiary care centre in Switzerland: an observational analysis.


Journal

Swiss medical weekly
ISSN: 1424-3997
Titre abrégé: Swiss Med Wkly
Pays: Switzerland
ID NLM: 100970884

Informations de publication

Date de publication:
13 07 2020
Historique:
entrez: 16 7 2020
pubmed: 16 7 2020
medline: 1 8 2020
Statut: epublish

Résumé

To describe admission characteristics, risk factors and outcomes of patients with coronavirus disease 2019 (COVID-19) hospitalised in a tertiary care hospital in Switzerland during the early phase of the pandemic. This retrospective cohort study included adult patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) testing and hospitalised at the cantonal hospital Aarau (Switzerland) between 26 February 2020 and 30 April 2020. Our primary endpoint was severe COVID-19 progression defined as a composite of transfer to the intensive care unit (ICU) and in-hospital mortality. A total of 99 patients (median age 67 years [interquartile range 56–76], 37% females) were included and 35% developed severe COVID-19 progression (24% needed ICU treatment, 19% died). Patients had a high burden of comorbidities with a median Charlson comorbidity index of 3 points and a high prevalence of hypertension (57%), chronic kidney disease (28%) and obesity (27%). Baseline characteristics with the highest prognostic value for the primary endpoint by means of area under the receiver operating characteristic curve were male gender (0.63) and initial laboratory values including shock markers (lactate on ambient air 0.67; lactate with O2 supply 0.70), markers of inflammation (C-reactive protein 0.72, procalcitonin 0.80) and markers of compromised oxygenation (pO2 0.75 on ambient air), whereas age and comorbidities provided little prognostic information. This analysis provides insights into the first consecutively hospitalised patients with confirmed COVID-19 at a Swiss tertiary care hospital during the initial period of the pandemic. Markers of disease progression such as inflammatory markers, markers for shock and impaired respiratory function provided the most prognostic information regarding severe COVID-19 progression in our sample.

Identifiants

pubmed: 32668007
doi: 10.4414/smw.2020.20316
pii: Swiss Med Wkly. 2020;150:w20316
doi:
pii:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

w20316

Commentaires et corrections

Type : CommentIn

Auteurs

Claudia Gregoriano (C)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland.

Daniel Koch (D)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland.

Sebastian Haubitz (S)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland / Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.

Anna Conen (A)

Medical Faculty, University of Basel, Switzerland / Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.

Christoph A Fux (CA)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland/ Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.

Beat Mueller (B)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland / Medical Faculty, University of Basel, Switzerland Medical Faculty, University of Basel, Basel, Switzerland.

Luca Bernasconi (L)

Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.

Angelika Hammerer-Lercher (A)

Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.

Micheal Oberle (M)

Department of Infectious Diseases and Hospital Hygiene, Kantonsspital Aarau, Switzerland.

Susanne Burgermeister (S)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland.

Hartwig Reiter (H)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland.

Alexander Kutz (A)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland.

Philipp Schuetz (P)

Medical University Department of Medicine, Kantonsspital Aarau, Switzerland / Medical Faculty, University of Basel, Switzerland.

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Classifications MeSH