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Covid-19: Patients hospitalised shortly after symptom onset likely to be more at risk, says study

Patients who are admitted to the hospital within a shorter span of time – from the onset of a symptom – are likely to be more at risk, according to a study presented earlier this week at the online ESCMID Conference on Coronavirus Disease.As per the study, “a shorter time from symptom onset to hospitalisation is associated with a more serious disease and death in patients with Covid-19.”The study was conducted by researchers at the University of Southern California (USC) School of Pharmacy.The researchers assessed Covid-19 patients presented to the Huntington Memorial Hospital, in Pasadena, California for care after varying duration of symptom onset.They evaluated the characteristics of the patients and the correlation between the timeline of symptoms prior to hospitalisation and the resultant outcomes of 252 patients.“All patients who were hospitalised from home due to Covid-19 between March 14, 2020 to May 14, 2020 with a positive PCR result for SARS-CoV-2 were evaluated via retrospective review of electronic medical records to obtain pertinent demographic, laboratory, and clinical information. Patients were grouped based on the time from onset of symptoms to hospitalisation and compared for clinical characteristics, treatment, and outcomes,” explained an official release.Out of the total number of patients, 33 per cent presented within 3 days while 27 per cent were brought in after 1 week from the onset of symptoms.The study found that patients admitted shortly (within 3 days) after symptom onset tended to be older (65 vs 58 years) and were more likely to have hypertension. 59 per cent of the patients had a history of hypertension. 14 per cent of the patients also had chronic kidney disease.The group had fewer symptoms overall such as fever (55 per cent), shortness of breath (48 per cent), non-productive cough (40 per cent,) and muscle/joint pain (12 per cent) as compared to the patients presented after a week.However, these patients also had higher levels of organ failure. They had a “worse overall assessment based on a severity score called APACHE II, which factors in physiology, age and chronic conditions.”“This quicker-presenting group also ultimately were more likely to develop acute respiratory distress syndrome and have higher mortality than those presenting at the hospital more than one week after symptom onset,” the study found.As per the further analysis of the study group, 55 per cent of these patients brought in within three days received antiviral therapy. However, even with therapy, the mortality rate remained high at 23 per cent in these patients.”Our findings suggest that patients with Covid-19 who had significant comorbidities became acutely ill with severe presentation shortly (within 3 days) following onset of symptoms and were at significant risk for complications and death despite receipt of antiviral therapy. Aggressive management and vaccine prioritisation should be directed at this patient population,” the authors concluded.

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