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Shorter time from symptom onset to hospitalization is associated with more serious disease and higher mortality in patients with COVID-19, suggests research presented at the 2020 ESCMID Conference on Coronavirus Disease (ECCVID).
The study by Annie Wong-Beringer, PharmD, FCCP, and colleagues, University of Southern California School of Pharmacy, Los Angeles, included 252 patients hospitalized due to COVID-19 between March 14 and May 14.
A third (33%) presented within 3 days of symptom onset, while 27% were admitted after 1 week from onset.
Patients presenting within 3 days after symptom onset tended to be older (65 vs 58 years) and were more likely to have hypertension (59% vs 41%) and chronic kidney disease (14% vs 3%) than those admitted after 1 week.
However, the group that presented within 3 days also had fewer symptoms overall such as fever (55% vs 66%), shortness of breath (48% vs 66%), nonproductive cough (40% vs 66%,) and muscle/joint pain (12% vs 26%), but had higher levels of organ failure and a worse overall assessment.
This quicker-presenting group were ultimately more likely to develop acute respiratory distress syndrome (13% vs 6%) and have higher mortality (15% vs 3%) than those presenting at hospital later.
Just over half the patients (55%) received antiviral therapy. Of these, the mortality rate was 23% in the patients who presented within 3 days compared with 5% in those presenting after 1 week.
Among those who did not receive antiviral therapy, mortality was 7% in the quicker-presenting group whereas none died in the group presenting after 7 days.
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Question: What are the clinical implications of your findings?
Wong-Beringer: "Clinicians should closely follow patients with underlying conditions such as hypertension and chronic kidney disease to ensure medication adherence and optimal disease control; and target these individuals for vaccine prioritization and aggressive management of COVID-19."
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ESCMID Conference on Coronavirus Disease (ECCVID) 2020: Abstract 00331. Presented September 23-25, 2020.
This article originally appeared on Univadis, part of the Medscape Professional Network.
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Cite this: Priscilla Lynch. Quick Hospitalization Linked to Worse Outcomes in COVID-19 - Medscape - Oct 08, 2020.
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