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Open AccessArticle

Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19

1
Center for Interventional Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USA
2
Department of Microbiology, Virginia Mason Medical Center, Seattle, WA 98101, USA
3
Center for Translational Immunology, Benaroya Research Institute at Virginia Mason, Seattle, WA 98101, USA
4
Department of Infectious Disease, Virginia Mason Medical Center, Seattle, WA 98101, USA
5
Department of Medicine, Section of Infectious Diseases, University of Washington, Seattle, WA 98101, USA
*
Author to whom correspondence should be addressed.
Authors contributed equally to the work.
Academic Editor: Luca Quartuccio
J. Clin. Med. 2021, 10(8), 1562; https://doi.org/10.3390/jcm10081562
Received: 14 February 2021 / Revised: 29 March 2021 / Accepted: 2 April 2021 / Published: 8 April 2021
Comprehensive data on early prognostic indicators in patients with mild COVID-19 remains sparse. In this single center case series, we characterized the initial clinical presentation in 180 patients with mild COVID-19 and defined the earliest predictors of subsequent deterioration and need for hospitalization. Three broad patient phenotypes and four symptom clusters were characterized, differentiated by varying risk for adverse outcomes. Among 14 symptoms assessed, subjective shortness of breath (SOB) most strongly associated with adverse outcomes (odds ratio (OR) 21.3, 95% confidence interval (CI): 2.7–166.4; p < 0.0001). In combination, SOB and number of comorbidities were highly predictive of subsequent hospitalization (area under the curve (AUC) 92%). Additionally, initial lymphopenia (OR 21.0, 95% CI: 2.1–210.1; p = 0.002) and male sex (OR 3.5, 95% CI: 0.9–13.0; p = 0.05) were associated with increased risk of poor outcomes. Patients with known comorbidities, especially multiple, and those presenting with subjective SOB or lymphopenia should receive close monitoring and consideration for preemptive treatment, even when presenting with mild symptoms. View Full-Text
Keywords: COVID-19; SARS CoV-2; pathophysiology; prognostic indicators; pandemic; comorbidities; lymphopenia; shortness of breath COVID-19; SARS CoV-2; pathophysiology; prognostic indicators; pandemic; comorbidities; lymphopenia; shortness of breath
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MDPI and ACS Style

Ylescupidez, A.; Rips, A.; Bahnson, H.T.; Speake, C.; Verma, P.; Hocking, A.M.; Buckner, J.H.; Malhotra, U. Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19. J. Clin. Med. 2021, 10, 1562. https://doi.org/10.3390/jcm10081562

AMA Style

Ylescupidez A, Rips A, Bahnson HT, Speake C, Verma P, Hocking AM, Buckner JH, Malhotra U. Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19. Journal of Clinical Medicine. 2021; 10(8):1562. https://doi.org/10.3390/jcm10081562

Chicago/Turabian Style

Ylescupidez, Alyssa; Rips, Aaron; Bahnson, Henry T.; Speake, Cate; Verma, Punam; Hocking, Anne M.; Buckner, Jane H.; Malhotra, Uma. 2021. "Early Prognostic Indicators of Subsequent Hospitalization in Patients with Mild COVID-19" J. Clin. Med. 10, no. 8: 1562. https://doi.org/10.3390/jcm10081562

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