Characteristics, predictors and outcomes among 99 patients hospitalised with COVID-19 in a tertiary care centre in Switzerland: an observational analysis.

Abstract

AIMS OF THE STUDY:

To describe admission characteristics, risk factors and outcomes of patients with coronavirus disease 2019 (COVID-19) hospitalised in a tertiary care hospital in Switzerland during the early phase of the pandemic.

METHODS:

This retrospective cohort study included adult patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) testing and hospitalised at the cantonal hospital Aarau (Switzerland) between 26 February 2020 and 30 April 2020. Our primary endpoint was severe COVID-19 progression defined as a composite of transfer to the intensive care unit (ICU) and in-hospital mortality.

RESULTS:

A total of 99 patients (median age 67 years [interquartile range 56–76], 37% females) were included and 35% developed severe COVID-19 progression (24% needed ICU treatment, 19% died). Patients had a high burden of comorbidities with a median Charlson comorbidity index of 3 points and a high prevalence of hypertension (57%), chronic kidney disease (28%) and obesity (27%). Baseline characteristics with the highest prognostic value for the primary endpoint by means of area under the receiver operating characteristic curve were male gender (0.63) and initial laboratory values including shock markers (lactate on ambient air 0.67; lactate with O2 supply 0.70), markers of inflammation (C-reactive protein 0.72, procalcitonin 0.80) and markers of compromised oxygenation (pO2 0.75 on ambient air), whereas age and comorbidities provided little prognostic information.

CONCLUSION:

This analysis provides insights into the first consecutively hospitalised patients with confirmed COVID-19 at a Swiss tertiary care hospital during the initial period of the pandemic. Markers of disease progression such as inflammatory markers, markers for shock and impaired respiratory function provided the most prognostic information regarding severe COVID-19 progression in our sample.

• Authors: Claudia Gregoriano, Daniel Koch, Sebastian Haubitz, Anna Conen, Christoph A Fux, Beat Mueller, Luca Bernasconi, Angelika Hammerer-Lercher, Micheal Oberle, Susanne Burgermeister, Hartwig Reiter, Alexander Kutz, Philipp Schuetz
• Journal: Swiss medical weekly (Swiss Med Wkly) Vol. 150 Pg. w20316 (07 13 2020) ISSN: 1424-3997 [Electronic] Switzerland
• PMID: 32668007 (Publication Type: Journal Article)

Topics

• Aged
• Betacoronavirus (isolation & purification)
• COVID-19
• Causality
• Comorbidity
• Coronavirus Infections (diagnosis, mortality, physiopathology, therapy)
• Disease Progression
• Female
• Hospital Mortality
• Hospitalization (statistics & numerical data)
• Humans
• Inflammation (blood)
• Male
• Pandemics
• Pneumonia, Viral (diagnosis, mortality, physiopathology, therapy)
• Retrospective Studies
• Risk Factors
• SARS-CoV-2
• Switzerland (epidemiology)
• Tertiary Care Centers (statistics & numerical data)