Objectives: COVID-19 may show no peculiar signs and symptoms that may differentiate it from other infective or non-infective etiologies; thus, early recognition and prompt management are crucial to improve survival. The aim of this study was to describe clinical, laboratory, and radiological characteristics and outcomes of hospitalized COVID-19 patients compared to those with other infective or non-infective etiologies. Methods: We performed a prospective study from March 2020 to February 2021. All patients hospitalized for suspected or confirmed COVID-19 were prospectively recruited. All patients were evaluated according to a predefined protocol for diagnosis of suspected SARS-CoV-2 infection. The primary endpoint was evaluation of clinical, laboratory, and radiological characteristics associated or not with COVID-19 etiology at time of hospitalization in an emergency department. Results: A total of 1036 patients were included in the study: 717 (69%) patients with confirmed COVID-19 and 319 (31%) without COVID-19, hospitalized for other causes. The main causes of hospitalization among non-COVID-19 patients were acute heart failure (44%) and bacterial pneumonia (45.8%). Overall, 30-day mortality was 9% among the COVID-19 group and 35% in the non-COVID-19 group. Multivariate analysis showed variables (fever > 3 days, dry cough, acute dyspnea, lymphocytes < 1000 × 10 3 /µL, and ferritin > 250 ng/mL) independently associated with COVID-19 etiology. A decision tree was elaborated to early detect COVID-19 patients in the emergency department. Finally, Kaplan–Meier curves on 30-day survival in COVID-19 patients during the first wave (March–May 2020, n = 289 patients) and the second wave (October–February 2021, n = 428 patients) showed differences between the two study periods ( p = 0.021). Conclusions: Patients with confirmed diagnosis of COVID-19 may show peculiar characteristics at time of hospitalization that could help physicians to distinguish from other infective or non-infective etiologies. Finally, a different 30-day mortality rate was observed during different periods of the pandemic.
【저자키워드】 COVID-19, SARS-CoV-2, Mortality, Acute respiratory failure, Fever, Decision tree, 【초록키워드】 pandemic, protocol, Hospitalized, Hospitalization, Pneumonia, SARS-COV-2 infection, Prospective Study, Diagnosis, ferritin, Symptom, outcome, Laboratory, lymphocyte, Acute heart failure, survival, Characteristics, management, Dyspnea, Patient, second wave, etiology, First wave, patients, Bacterial, Multivariate analysis, 30-Day mortality, hospitalized COVID-19 patient, primary endpoint, COVID-19 patient, causes, dry cough, study period, help, COVID-19 group, physician, non-COVID-19 group, infective, variable, Kaplan–Meier, radiological, etiologies, 30-day mortality rate, IMPROVE, performed, detect, recruited, evaluated, cause, diagnosis of COVID-19, non-COVID-19 patient, patients hospitalized, with COVID-19, 【제목키워드】 clinical, Emergency, Department, Suspected,