tetano
Editor, Senior Moderator
J Assoc Med Microbiol Infect Dis Can
. 2021 Dec 3;6(4):259-268.
doi: 10.3138/jammi-2021-0012. eCollection 2021 Dec.
Association between initial symptoms and subsequent hospitalization in outpatients with COVID-19: A cohort study
Alice Zhabokritsky[SUP] 1 [/SUP], Nick Daneman[SUP] 1 2 [/SUP], Scott MacPhee[SUP] 3 [/SUP], Jose Estrada-Codecido[SUP] 4 [/SUP], Aimee Santoro[SUP] 5 [/SUP], Adrienne Kit Chan[SUP] 1 2 [/SUP], Philip Wai-Hei Lam[SUP] 1 2 [/SUP], Andrew Simor[SUP] 1 2 [/SUP], Jerome Allen Leis[SUP] 1 2 [/SUP], Samira Mubareka[SUP] 1 2 [/SUP], Nisha Andany[SUP] 1 2 [/SUP]
Affiliations
Abstract
in English, French
Background: Most individuals with coronavirus disease 2019 (COVID-19) experience mild symptoms and are managed in the outpatient setting. The aim of this study was to determine whether self-reported symptoms at the time of diagnosis can identify patients at risk of clinical deterioration.
Methods: This was a retrospective cohort study of 671 outpatients with laboratory-confirmed COVID-19 diagnosed in Toronto between March 1 and October 16, 2020. We examined the association between patients' baseline characteristics and self-reported symptoms at the time of diagnosis and the risk of subsequent hospitalization.
Results: Of 671 participants, 26 (3.9%) required hospitalization. Individuals aged 65 years or older were more likely to require hospitalization (odds ratio [OR] 5.29, 95% CI 2.19 to 12.77), whereas those without medical comorbidities were unlikely to be hospitalized (OR 0.02, 95% CI 0.00 to 0.17). After adjusting for age and presence of comorbidities, sputum production (adjusted OR [aOR] 5.01, 95% CI 1.97 to 12.75), arthralgias (aOR 4.82, 95% CI 1.85 to 12.53), diarrhea (aOR 4.56, 95% CI 1.82 to 11.42), fever (aOR 3.64, 95% CI 1.50 to 8.82), chills (aOR 3.62, 95% CI 1.54 to 8.50), and fatigue (aOR 2.59, 95% CI 1.04 to 6.47) were associated with subsequent hospitalization.
Conclusions: Early assessment of symptoms among outpatients with COVID-19 can help identify individuals at risk of clinical deterioration. Additional studies are needed to determine whether more intense follow-up and early intervention among high-risk individuals can alter the clinical trajectory of and outcomes among outpatients with COVID-19.
Keywords: COVID-19; hospitalization; outpatients; symptoms.
. 2021 Dec 3;6(4):259-268.
doi: 10.3138/jammi-2021-0012. eCollection 2021 Dec.
Association between initial symptoms and subsequent hospitalization in outpatients with COVID-19: A cohort study
Alice Zhabokritsky[SUP] 1 [/SUP], Nick Daneman[SUP] 1 2 [/SUP], Scott MacPhee[SUP] 3 [/SUP], Jose Estrada-Codecido[SUP] 4 [/SUP], Aimee Santoro[SUP] 5 [/SUP], Adrienne Kit Chan[SUP] 1 2 [/SUP], Philip Wai-Hei Lam[SUP] 1 2 [/SUP], Andrew Simor[SUP] 1 2 [/SUP], Jerome Allen Leis[SUP] 1 2 [/SUP], Samira Mubareka[SUP] 1 2 [/SUP], Nisha Andany[SUP] 1 2 [/SUP]
Affiliations
- PMID: 36338454
- PMCID: PMC9629262
- DOI: 10.3138/jammi-2021-0012
Abstract
in English, French
Background: Most individuals with coronavirus disease 2019 (COVID-19) experience mild symptoms and are managed in the outpatient setting. The aim of this study was to determine whether self-reported symptoms at the time of diagnosis can identify patients at risk of clinical deterioration.
Methods: This was a retrospective cohort study of 671 outpatients with laboratory-confirmed COVID-19 diagnosed in Toronto between March 1 and October 16, 2020. We examined the association between patients' baseline characteristics and self-reported symptoms at the time of diagnosis and the risk of subsequent hospitalization.
Results: Of 671 participants, 26 (3.9%) required hospitalization. Individuals aged 65 years or older were more likely to require hospitalization (odds ratio [OR] 5.29, 95% CI 2.19 to 12.77), whereas those without medical comorbidities were unlikely to be hospitalized (OR 0.02, 95% CI 0.00 to 0.17). After adjusting for age and presence of comorbidities, sputum production (adjusted OR [aOR] 5.01, 95% CI 1.97 to 12.75), arthralgias (aOR 4.82, 95% CI 1.85 to 12.53), diarrhea (aOR 4.56, 95% CI 1.82 to 11.42), fever (aOR 3.64, 95% CI 1.50 to 8.82), chills (aOR 3.62, 95% CI 1.54 to 8.50), and fatigue (aOR 2.59, 95% CI 1.04 to 6.47) were associated with subsequent hospitalization.
Conclusions: Early assessment of symptoms among outpatients with COVID-19 can help identify individuals at risk of clinical deterioration. Additional studies are needed to determine whether more intense follow-up and early intervention among high-risk individuals can alter the clinical trajectory of and outcomes among outpatients with COVID-19.
Keywords: COVID-19; hospitalization; outpatients; symptoms.