Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19

Comprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospi...

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Bibliographic Details
Published in:Journal of clinical medicine 2021-04, Vol.10 (8), p.1562
Main Authors: Ylescupidez, Alyssa, Rips, Aaron, Bahnson, Henry T, Speake, Cate, Verma, Punam, Hocking, Anne M, Buckner, Jane H, Malhotra, Uma
Format: Article
Language:English
Subjects:
Anorexia
Clinical medicine
Clinical outcomes
Coronaviruses
COVID-19
Generalized linear models
Hospitalization
Illnesses
Medical prognosis
Nausea
Patients
Pneumonia
Severe acute respiratory syndrome coronavirus 2
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Summary:Comprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospitalization. Three broad patient phenotypes and four symptom clusters were characterized, differentiated by varying risk for adverse outcomes. Among 14 symptoms assessed, subjective shortness of breath (SOB) most strongly associated with adverse outcomes (odds ratio (OR) 21.3, 95% confidence interval (CI): 2.7-166.4; < 0.0001). In combination, SOB and number of comorbidities were highly predictive of subsequent hospitalization (area under the curve (AUC) 92%). Additionally, initial lymphopenia (OR 21.0, 95% CI: 2.1-210.1; = 0.002) and male sex (OR 3.5, 95% CI: 0.9-13.0; = 0.05) were associated with increased risk of poor outcomes. Patients with known comorbidities, especially multiple, and those presenting with subjective SOB or lymphopenia should receive close monitoring and consideration for preemptive treatment, even when presenting with mild symptoms.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm10081562