Clinical and virological characteristics of hospitalised COVID-19 patients in a German tertiary care centre during the first wave of the SARS-CoV-2 pandemic: a prospective observational study
Creators: name: Thibeault, Charlotte
name: Mühlemann, Barbara
name: Helbig, Elisa T.
name: Mittermaier, Mirja
name: Lingscheid, Tilman
name: Tober-Lau, Pinkus
name: Meyer-Arndt, Lil A.
name: Meiners, Leonie
name: Stubbemann, Paula
name: Haenel, Sascha S.
name: Bosquillon De Jarcy, Laure
name: Lippert, Lena
name: Pfeiffer, Moritz
name: Stegemann, Miriam S.
name: Roehle, Robert
name: Wiebach, Janine
name: Hippenstiel, Stefan
name: Zoller, Thomas
name: Müller-Redetzky, Holger
name: Uhrig, Alexander
name: Balzer, Felix
name: Kalle, Christof Von
name: Suttorp, Norbert
name: Jones, Terry C.
name: Drosten, Christian
name: Witzenrath, Martin
name: Sander, Leif E.
name: Jürgens, Linda
name: Kleinschmidt, Malte
name: Denker, Sophy
name: Ruwwe-Glösenkamp, Christoph
name: Temmesfeld-Wollbrück, Bettina
name: Heim, Katrin M.
name: Schürmann, Dirk
name: Hocke, Andreas
name: Opitz, Bastian
name: Pascual-Leone, Belén Millet
name: Schuhmacher, Rosa C.
name: Olk, Nadine
name: Hillus, David
name: Machleidt, Felix
name: Albus, Sebastian
name: Bremer, Felix
name: Doehn, Jan-Moritz
name: Garcia, Carmen
name: Knape, Philipp
name: Krause, Philipp M.
name: Lechtenberg, Liron
name: Li, Yaosi
name: Pergantis, Panagiotis
name: Ritter, Teresa
name: Yedikat, Berna
name: Zobel, Christian
name: Hefele, Friederike L.
name: Kellermann, Ute
name: Schürmann, Mariana
name: Wackernagel, Lisa-Marie
name: Wetzel, Anne
name: Grund, Daniel
name: Haumesser, Jens K.
name: Hodes, Johannes
name: Rein, Johannes
name: Radünzel, Peter
name: Breitbart, Astrid
name: Münzenberg, Sergej
name: Soll, Dominik
name: Zhamurashvili, Tamar
name: Hübner, Ralf-Harto
name: Alius, Florian
name: Andermann, Tim
name: Cronen, Thomas
name: Fraumann, Simon
name: Frost, Nikolaj
name: Geus, Dominik
name: Godzick-Njomgang, Gisele J.
name: Herholz, Anne
name: Hermanns, Vera
name: Hilbrandt, Moritz
name: Jacobi, Till
name: Kim, Ye-Ji
name: Madlung, Elena
name: Martin, Luise
name: Menner, Nikolai
name: Mikolajewska, Agata
name: Mrziglod, Luisa
name: Muller, Nadine
name: Niebank, Michaela
name: Pappe, Eva
name: Pfäfflin, Frieder
name: Pfannkuch, Lennart
name: Raspe, Matthias
name: Reck, Nicola
name: Ritter, Anne
name: Saccomanno, Jacopo
name: Schmalbrock, Laura K.
name: Steinbeis, Fridolin
name: Tabeling, Christoph
name: Vogtmann, Markus
name: Weber, Susanne
name: Brack, Markus
name: Felten, Matthias
name: Schmidt, Sein
name: Rönnefarth, Maria
name: Schwanitz, Georg
name: Krannich, Alexander
name: Zvorc, Saskia
name: Behrens, Uwe D.
name: Kretzler, Lucie
name: Li, Linna
name: Wirsching, Isabelle
name: Dang-Heine, Chantip
name: Hummel, Michael
name: Briesemeister, Dana
name: Treue, Denise
name: Möckel, Martin
name: Knauß, Samuel
name: Endres, Matthias
name: Spies, Claudia
name: Weber-Carstens, Steffen
name: Kruse, Jan M.
name: Zickler, Daniel
name: Edel, Andreas
name: Stier, Britta
name: Enghard, Philipp
name: Körner, Roland
name: Eckardt, Kai-Uwe
name: Elbert, Lucas
name: Neumann, Christopher
name: Eckart, Marius A.
name: Pham, Thuy N.
name: Schönberger, Solveig
name: Wree, Alexander
name: Tacke, Frank
name: Mang, Josef
name: Vries, Nadia A. De
name: Wittenberg, Marcel
name: Riecke, Jana
name: Heeschen, Julia
name: Treskatsch, Sascha
name: Angermair, Stefan
name: Dijck, Phillip Van
name: Corman, Victor M.
name: Kurth, Florian
name: Pa-COVID Study Group
Publisher: name: Charité - Universitätsmedizin Berlin
Year: 2021
Subjects: subject: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
subject: Coronavirus disease 2019 (COVID-19)
subject: Viral concentration
subject: COVID-19 nucleic acid testing
subject: Respiratory distress syndrome
subject: Mechanical ventilation
subject: Artificial respiration
subject: Prospective study
subject: Symptom assessment
subject: 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit

description: Purpose: Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course. Methods: A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed. Results: Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10-1.37, p &lt; 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00-16.82, p &lt; 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26-46.75, vs 18 days, IQR 16-46.75, respectively, p &lt; 0.01). Median duration of hospitalisation was 9 days (IQR 6-15.5) for non-IMV and 49.5 days (IQR 36.8-82.5) for IMV patients. Conclusions: Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19.