Stop COVID Cohort: An Observational Study of 3480 Patients Admitted to the Sechenov University Hospital Network in Moscow City for Suspected Coronavirus Disease 2019 (COVID-19) Infection
Когорта Stop COVID: обсервационное исследование 3480 пациентов, госпитализированных в сеть клиник Университета имени И. М. Сеченова в Москве с подозрением на инфекцию, вызванную коронавирусной болезнью 2019 года (COVID-19)
2020-10-06
SCID: 54.1/umbm9zrs
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COVID-19SARS-CoV-2 RT-PCRchronic comorbiditiesclinical diagnosisin-hospital mortality
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Abstract (AI)
BACKGROUND: The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking. METHODS: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020. RESULTS: Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47). CONCLUSIONS: Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.
Key Findings
1
Among 3480 hospitalized adults with suspected COVID-19 in Moscow, half had positive RT-PCR results and half were clinically diagnosed despite negative RT-PCR.
2
Clinical symptoms combined with characteristic computed tomography findings were sufficient for COVID-19 diagnosis, suggesting laboratory confirmation was not essential in real-world practice.
3
Clinically diagnosed and RT-PCR-confirmed patients showed no significant differences in symptoms, laboratory findings, or in-hospital mortality risk factors.
4
Mortality odds increased by 5% per additional year of age; male sex, chronic kidney disease, and dementia showed particularly elevated associations.
5
Older age, male sex, chronic kidney disease, diabetes, chronic cardiovascular disease, and dementia were independently associated with higher in-hospital mortality.
Research Object
Adult patients admitted to the Sechenov University Hospital Network in Moscow for suspected COVID-19 infection
Research Subject
Epidemiology, clinical presentation, diagnostic concordance between clinical diagnosis and SARS-CoV-2 RT-PCR, and risk factors for in-hospital mortality
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2020-10-06
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