Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms
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(Published version)
Date
2024
Authors
Citarella, B.W.
Kartsonaki, C.
Ibáñez-Prada, E.D.
Gonçalves, B.P.
Baruch, J.
Escher, M.
Pritchard, M.G.
Wei, J.
Philippy, F.
Dagens, A.
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Journal article
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Heliyon, 2024; 10(10):e29591-1-e29591-16
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Barbara Wanjiru Citarella ... et al., the ISARIC Clinical Characterisation Group
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Abstract
Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4 % presented with RS, while 13.6 % had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7 % vs RS: 37.5 %). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1 % vs. RS 32.0 %), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83–0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders.
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Available online 4 May 2024
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© 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).