Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

the ISARIC Clinical Characterisation Group

doi:10.1016/j.heliyon.2024.e29591

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

the ISARIC Clinical Characterisation Group

Producción científica: Revista › Artículo › revisión exhaustiva

1 Cita (Scopus)

Resumen

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

Idioma original	Inglés
Número de artículo	e29591
Publicación	Heliyon
Volumen	10
N.º	10
DOI	https://doi.org/10.1016/j.heliyon.2024.e29591
Estado	Publicada - 30 may. 2024
Publicado de forma externa	Sí

Nota bibliográfica

Publisher Copyright:
© 2024 The Authors

Financiación

Financiadores	Número del financiador
Vysnova Partners, Inc.
Department of Health and Social Care
Michigan Institute for Clinical and Health Research
Kementerian Kesihatan Malaysia
Sunnybrook Research Institute
Seventh Framework Programme
Institut national de la santé et de la recherche médicale
Artificial Intelligence for Pandemics
Department of Anaesthesia, Intensive Care Medicine and Pain Medicine
Italian Ministry of Health “Fondi Ricerca corrente
Ministère des Affaires Sociales et de la Santé
Groote Schuur Hospital Covid ICU
Irish Critical Care- Clinical Trials Group
United Kingdom
Saisei Pharma
National Institutes of Health
South Eastern Norway Health Authority and the Research Council of Norway
COVID-19 Clinical Management team
National Institute for Health Research Health Protection Research Unit
University of Queensland
Manipal Hospital Whitefield
foundation Bevordering Onderzoek Franciscus
Universityof CapeTown
Saisei Mirai
University College Dublin
Firland Foundation
Lao-Oxford-Mahosot Hospital-Wellcome Trust
HPRU
Foreign, Commonwealth and Development Office
Medizinische Universität Wien
Liverpool Experimental Cancer Medicine Centre	C18616/A25153
U.S. DoD Armed Forces Health Surveillance Division, Global Emerging Infectious Diseases Branch	P0153_21_N2
PHRC	APCOV22BGM, 20-0424
Wellcome Trust	220757/Z/20/Z, 220757, 215091/Z/18/Z, 225288, 225288/Z/22/Z, 222410/Z/21/Z, 222410, 215091
NIHR Biomedical Research Centre at Imperial College London	ISBRC-1215-20013
Medical Research Council	MR/V033441/1, MC_PC_19059
Norges Forskningsråd	312780
National Institute for Health and Care Research	CO-CIN-01/DH_/
Australian Department of Health	3273191
Health Research Board	CTN-2014-12
Australian Research Council	CE170100009
Canadian Institutes of Health Research	OV2170359
Public Health England	200907
Imperial College London	200927
Medical Research Council (UK Research and Innovation	MC_UU_00031/7, MC_PC_19084, NIHR201385
Prince Charles Hospital Foundation	303953/2018- 7
Bill and Melinda Gates Foundation	0009109, OPP1209135
Innovative Medicines Initiative	115523
European Federation of Pharmaceutical Industries and Associations	NCT04262921
Horizon 2020 Framework Programme	101003589
Manchester Biomedical Research Centre	NIHR203312
European Clinical Research Alliance on Infectious Diseases	965313

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10.1016/j.heliyon.2024.e29591

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@article{a1fff84837d7491aa19bae32acc61423,

title = "Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms",

abstract = "Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 \% presented with RS, while 13.6 \% had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 \% vs RS: 37.5 \%). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 \% vs. RS 32.0 \%), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.",

keywords = "COVID-19, Mortality, Non-respiratory symptoms, Respiratory symptoms, Risk factors",

author = "\{the ISARIC Clinical Characterisation Group\} and Citarella, \{Barbara Wanjiru\} and Christiana Kartsonaki and Ib{\'a}{\~n}ez-Prada, \{Elsa D.\} and Gon{\c c}alves, \{Bronner P.\} and Joaquin Baruch and Martina Escher and Pritchard, \{Mark G.\} and Jia Wei and Fred Philippy and Andrew Dagens and Matthew Hall and James Lee and Kutsogiannis, \{Demetrios James\} and Wils, \{Evert Jan\} and Fernandes, \{Mar{\'i}lia Andreia\} and \{Tirupakuzhi Vijayaraghavan\}, \{Bharath Kumar\} and Panda, \{Prasan Kumar\} and Ignacio Martin-Loeches and Shinichiro Ohshimo and Fatoni, \{Arie Zainul\} and Peter Horby and Jake Dunning and Jordi Rello and Laura Merson and Amanda Rojek and Michel Vaillant and Piero Olliaro and Reyes, \{Luis Felipe\} and Moharam, \{S. A.\} and Sabriya Abdalasalam and Abdalhadi, \{Alaa Abdalfattah\} and Abdalla, \{Naana Reyam\} and Walaa Abdalla and Abdalrheem, \{Almthani Hamza\} and Ashraf Abdalsalam and Saedah Abdeewi and Abdelgaum, \{Esraa Hassan\} and Mohamed Abdelhalim and Mohammed Abdelkabir and Israa Abdelrahman and Abdukahil, \{Sheryl Ann\} and Abdulbaqi, \{Lamees Adil\} and Salaheddin Abdulhamid and Widyan Abdulhamid and Abdulkadir, \{Nurul Najmee\} and Eman Abdulwahed and Rawad Abdunabi and Ryuzo Abe and Laurent Abel and Ruth Jimbo-Sotomayor",

note = "Publisher Copyright: {\textcopyright} 2024 The Authors",

year = "2024",

month = may,

day = "30",

doi = "10.1016/j.heliyon.2024.e29591",

language = "English",

volume = "10",

journal = "Heliyon",

issn = "2405-8440",

publisher = "Elsevier Ltd",

number = "10",

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TY - JOUR

T1 - Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

AU - the ISARIC Clinical Characterisation Group

AU - Citarella, Barbara Wanjiru

AU - Kartsonaki, Christiana

AU - Ibáñez-Prada, Elsa D.

AU - Gonçalves, Bronner P.

AU - Baruch, Joaquin

AU - Escher, Martina

AU - Pritchard, Mark G.

AU - Wei, Jia

AU - Philippy, Fred

AU - Dagens, Andrew

AU - Hall, Matthew

AU - Lee, James

AU - Kutsogiannis, Demetrios James

AU - Wils, Evert Jan

AU - Fernandes, Marília Andreia

AU - Tirupakuzhi Vijayaraghavan, Bharath Kumar

AU - Panda, Prasan Kumar

AU - Martin-Loeches, Ignacio

AU - Ohshimo, Shinichiro

AU - Fatoni, Arie Zainul

AU - Horby, Peter

AU - Dunning, Jake

AU - Rello, Jordi

AU - Merson, Laura

AU - Rojek, Amanda

AU - Vaillant, Michel

AU - Olliaro, Piero

AU - Reyes, Luis Felipe

AU - Moharam, S. A.

AU - Abdalasalam, Sabriya

AU - Abdalhadi, Alaa Abdalfattah

AU - Abdalla, Naana Reyam

AU - Abdalla, Walaa

AU - Abdalrheem, Almthani Hamza

AU - Abdalsalam, Ashraf

AU - Abdeewi, Saedah

AU - Abdelgaum, Esraa Hassan

AU - Abdelhalim, Mohamed

AU - Abdelkabir, Mohammed

AU - Abdelrahman, Israa

AU - Abdukahil, Sheryl Ann

AU - Abdulbaqi, Lamees Adil

AU - Abdulhamid, Salaheddin

AU - Abdulhamid, Widyan

AU - Abdulkadir, Nurul Najmee

AU - Abdulwahed, Eman

AU - Abdunabi, Rawad

AU - Abe, Ryuzo

AU - Abel, Laurent

AU - Jimbo-Sotomayor, Ruth

PY - 2024/5/30

Y1 - 2024/5/30

N2 - Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

AB - Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.

KW - COVID-19

KW - Mortality

KW - Non-respiratory symptoms

KW - Respiratory symptoms

KW - Risk factors

UR - https://www.scopus.com/pages/publications/85192803986

U2 - 10.1016/j.heliyon.2024.e29591

DO - 10.1016/j.heliyon.2024.e29591

M3 - Article

AN - SCOPUS:85192803986

SN - 2405-8440

VL - 10

JO - Heliyon

JF - Heliyon

IS - 10

M1 - e29591

ER -

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Resumen

Nota bibliográfica

Financiación

ODS de las Naciones Unidas

Acceder al documento

Otros archivos y enlaces

Huella

Citar esto