Pulmonary function impairment of asymptomatic and persistently symptomatic patients 4 months after COVID-19 according to disease severity

Abstract Objective Evaluation of pulmonary function impairment after COVID-19 in persistently symptomatic and asymptomatic patients of all disease severities and characterisation of risk factors. Methods Patients with confirmed SARS-CoV-2 infection underwent prospective follow-up with pulmonary function testing and blood gas analysis during steady-state cycle exercise 4 months after acute illness. Pulmonary function impairment (PFI) was defined as reduction below 80% predicted of DLCOcSB, TLC, FVC, or FEV1. Clinical data were analyzed to identify risk factors for impaired pulmonary function. Results 76 patients were included, hereof 35 outpatients with mild disease and 41 patients hospitalized due to COVID-19. Sixteen patients had critical disease requiring mechanical ventilation, 25 patients had moderate–severe disease. After 4 months, 44 patients reported persisting respiratory symptoms. Significant PFI was prevalent in 40 patients (52.6%) occurring among all disease severities. The most common cause for PFI was reduced DLCOcSB (n = 39, 51.3%), followed by reduced TLC and FVC. The severity of PFI was significantly associated with mechanical ventilation (p < 0.001). Further risk factors for DLCO impairment were COPD (p < 0.001), SARS-CoV-2 antibody-Titer (p = 0.014) and in hospitalized patients CT score. A decrease of paO2 > 3 mmHg during cycle exercise occurred in 1/5 of patients after mild disease course. Conclusion We characterized pulmonary function impairment in asymptomatic and persistently symptomatic patients of different severity groups of COVID-19 and identified further risk factors associated with persistently decreased pulmonary function. Remarkably, gas exchange abnormalities were revealed upon cycle exercise in some patients with mild disease courses and no preexisting pulmonary condition.

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526. Clinical Presenting Characteristics of Pediatric COVID-19 Infection in a Tertiary Care Children’s Hospital in Detroit

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.720 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S330-S330

Author(s):

Jocelyn Y Ang ◽

Nirupama Kannikeswaran ◽

Basim Asmar

Keyword(s):

Mechanical Ventilation ◽

Severe Disease ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Signs And Symptoms ◽

Pediatric Emergency ◽

Study Cohort ◽

Mild Disease ◽

Presenting Symptoms ◽

Patient Disposition

Abstract Background There is limited data regarding the presenting clinical characteristics of COVID-19 in children. Our objective is to describe the clinical presentations and outcomes of COVID-19 infection early in the pandemic at our institution. Methods We performed a retrospective chart review of children up to 18 years who underwent testing for SARS CoV-2 from March 1st to May 10th 2020 at our pediatric emergency department. We abstracted patient’s demographics, clinical presentation, diagnostic studies and patient disposition. We classified the severity of clinical illness based on published criteria. We excluded patients diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. Results SARS CoV-2 testing was performed on 481 patients of whom 43 (8.9%) tested positive. Of these, 4 were diagnosed with MIS-C. Data of 39 patients were analyzed. Patients’ demographics, co-morbidities, presenting signs and symptoms and disposition are shown in Table 1. Age range was 47 days – 18 years. Infants representing one third (14/39; 35.9%) of our study cohort. There was equal sex distribution. Asthma or obesity was present in 17 (44%). The most common presenting symptoms included fever, cough, shortness of breath and diarrhea. Chest radiograph showed pneumonia in 12 (30.8%) patients. Two thirds (27/39; 69.2%) were asymptomatic or had mild disease; six patients (15.4%) had severe or critical illness (Figure 1). Nineteen (48%) patients were admitted to the general pediatric service. Eleven (28%) were admitted to the Intensive Care Units (ICU). The characteristics, presenting symptoms and interventions performed in the PICU cohort are shown in Table 2. Half of these patients required mechanical ventilation. There was one death in a 3 month old infant unrelated to SARS CoV-2. Majority of the infants required hospitalization (12/14; 85.7%), including 4 to the PICU (one each for non accidental trauma, ingestion, seizure and pneumonia). Table 1. Patient demographics, signs and symptoms of COVID-19 infection in Children Table 2: PICU patients: Characteristics, Interventions and pharmacotherapy Figure 1: Severity of Ill ness in the study cohort Conclusion Majority (17; 43%) of our children with COVID-19 had a mild disease. Eleven (28%) including 4 infants required critical care; 5 required mechanical ventilation. There was no COVID-19 related mortality. Larger studies are needed to further define the spectrum of COVID- 19 and risk factors associated with severe disease in children. Disclosures All Authors: No reported disclosures

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Effect of high frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of acute respiratory distress syndrome after cardiac surgery: a prospective randomized controlled trail

10.21203/rs.3.rs-247872/v1 ◽

2021 ◽

Author(s):

Yi-Rong Zheng ◽

Yu-Qing Lei ◽

Jian-Feng Liu ◽

Hong-Lin Wu ◽

Ning Xu ◽

...

Keyword(s):

Mechanical Ventilation ◽

Cardiac Surgery ◽

High Frequency ◽

Pulmonary Surfactant ◽

Distress Syndrome ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

High Frequency Oscillatory ◽

Length Of Hospitalization

Abstract Objective: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery.Method: A total of 61 infants with ARDS were eligible and were randomized to the CMV + PS group (n= 30) or the HFOV + PS group (n= 31) between January 2020 and December 2020. The primary outcomes were the improvement of the arterial blood gas analysis. The incidence of mechanical ventilation duration, length of hospitalization, and the incidence of complications were considered as secondary outcomes.Results: A total of 61 infants completed the study. In HFOV + PS group, the blood gas analysis results were significantly improved (P<0.05), while, duration of mechanical ventilation and length of hospitalization were shorter than CMV + PS group (P<0.05). But the incidences of complications had no statistical significance between the two groups (P>0.05).Conclusions: Compared with the CMV + PS group, HFOV + PS significantly improved the ABG variables and shortened the length of hospitalization and mechanical ventilation in infants with ARDS after cardiac surgery.

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The evaluation of pulmonary function and blood gas analysis in patients submitted to laparoscopic versus open nephrectomy

International braz j urol ◽

10.1590/s1677-5538.ibju.2015.0040 ◽

2015 ◽

Vol 41 (6) ◽

pp. 1202-1208 ◽

Cited By ~ 5

Author(s):

Ayfer Koc ◽

Gozde Inan ◽

Fusun Bozkirli ◽

Demet Coskun ◽

Lutfi Tunc

Keyword(s):

Pulmonary Function ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Open Nephrectomy

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Platelet Count in Patients with Mild Disease at Admission is Associated with Progression to Severe Hantavirus Cardiopulmonary Syndrome

Viruses ◽

10.3390/v11080693 ◽

2019 ◽

Vol 11 (8) ◽

pp. 693 ◽

Cited By ~ 1

Author(s):

René López ◽

Cecilia Vial ◽

Jerónimo Graf ◽

Mario Calvo ◽

Marcela Ferrés ◽

...

Keyword(s):

Mechanical Ventilation ◽

Platelet Count ◽

Severe Disease ◽

Tertiary Care ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Mild Disease ◽

Laboratory Variables ◽

Advanced Support ◽

Tertiary Care Centers

Background: Hantavirus cardiopulmonary syndrome (HCPS) has a mortality up to 35–40% and its treatment is mainly supportive. A variable to predict progression from mild to severe disease is unavailable. This study was performed in patients with documented infection by Andes orthohantavirus, and the aim was to find a simple variable to predict progression to moderate/severe HCPS in patients with mild disease at admission. Methods: We performed a retrospective analysis of 175 patients between 2001 and 2018. Patients were categorized into mild, moderate, and severe disease according to organ failure and advanced support need at hospital admission (e.g., mechanical ventilation, vasopressors). Progression to moderate/severe disease was defined accordingly. Clinical and laboratory variables associated with progression were explored. Results: Forty patients with mild disease were identified; 14 of them progressed to moderate/severe disease. Only platelet count was different between those who progressed versus those that did not (37 (34–58) vs. 83 (64–177) K/mm3, p < 0.001). A ROC curve analysis showed an AUC = 0.889 (0.78–1.0) p < 0.001, with a platelet count greater than 115K /mm3 ruling out progression to moderate/severe disease. Conclusions: In patients with mild disease at presentation, platelet count could help to define priority of evacuation to tertiary care centers.

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The Effect of Optimized Ultrafiltration on Perioperative Pulmonary Function During Cardiopulmonary Bypass in Infants Under 10 kg

Frontiers in Pediatrics ◽

10.3389/fped.2021.602034 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jianhong Niu ◽

Guangdi Zhai ◽

Aibin Zheng ◽

Juanying Zhou ◽

Shengqi Jiang ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Treatment Group ◽

Lung Function ◽

Pulmonary Function ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Combination Method ◽

Control Group ◽

Acid Base Balance ◽

Significant Difference

Objective: This study aims to investigate the effect of optimized ultrafiltration on perioperative electrolytes, acid–base balance, and pulmonary function during cardiopulmonary bypass (CPB) in infants with low body weight (under 10 kg), using traditional balanced ultrafiltration and modified ultrafiltration.Methods: A total of 30 children who underwent surgical correction for congenital heart disease in Changzhou Children's Hospital between January 2018 and December 2019 were randomly divided into two groups. In the treatment group, ultrafiltration pre-treatment was carried out with blood-containing priming fluid prior to CPB. Balanced ultrafiltration was performed during the operation, and optimized and modified ultrafiltration were conducted before closing and extubation. In the control group, traditional balanced ultrafiltration was used during the operation, and a modified ultrafiltration combination was used before closing and extubation. Indexes such as blood gas analysis and electrolytes were measured perioperatively, and pulmonary function was observed.Results: No deaths were reported in either group. The ventilator-assisted breathing time was shorter in the treatment group than in the control group (P < 0.05). The indexes of the treatment group were closer than those of the control group to the optimal physiological values. The concentrations of potassium ion (K+), lactate (Lac), and blood glucose (Glu) decreased, and there was significant difference between the two groups (P < 0.05) at the end of CPB. Hemoglobin (Hb) and hematocrit (HCT) in the treatment group increased (P < 0.01). Alveolar-arterial differences for oxygen (A-aDO2) and respiratory index (RI) increased significantly in both groups after operation. Children in the treatment group began to recover lung function earlier than children in the control group. Both A-aDO2 and RI were lower in the treatment group than in the control group at each time point after operation (P < 0.05).Conclusion: Optimizing and modifying the traditional ultrafiltration combination method can effectively shorten the ultrafiltration time, reduce the adverse impacts of the ultrafiltration technique, and improve the lung function of infants after operation.

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Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

10.21203/rs.2.13157/v1 ◽

2019 ◽

Author(s):

Han Han ◽

Xiao-xia Li ◽

Xiang-hua Shuai ◽

Zhi-qun Zhang ◽

Jing Li ◽

...

Keyword(s):

Mechanical Ventilation ◽

Rescue Therapy ◽

Total Duration ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Systemic Hemodynamic ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Background: Mechanical ventilation joint PS replacement therapy is an effective method in treatment of NRDS recognized, PS treatment of children with early can improve the oxygenation by increasing gas exchange area, but before FiO 2 to reduce the application of PS can cause local and/or systemic hemodynamic changes, making the use of PS has some potential problems, such as increasing the incidence of the IVH, PH, PDA and so on. SR rescue therapy can be divided into early treatment and delayed treatment, but the specific boundary point of the appropriate time period has not been clear. This paper aims to compare the efficacy differences of PS administration at different time periods and provide basis for the selection of clinical application period of PS. Methods: Case-control study . 135 children diagnosed with NRDS in neonatology department of our hospital. The patients were divided into two groups according to the use time of PS. Group A was applied within 3 hours after birth, and group B was applied 3 hours after birth. The changes of blood gas analysis parameter，mechanical ventilation time, incidence of complications, hospital stay and mortality were compared between the two groups. Results : The decrease of blood gas PaCO 2 in group A before and after treatment was more significant than that of group B (P<0.05), but the improvement of PaO 2 and OI in group B was better than that in group A (P<0.05). Although there were significant differences in birth weight between the two groups, there were no significant differences in the total duration of mechanical ventilation and mortality (P>0.05). Except PDA and BPD, there was no significant difference in the incidence of common complications between the two groups. Conclusion: PS treatment within 3 hours after birth can better improve ventilation, reduce the incidence of PDA. It can also help to reduce the death rate of high-risk children and the total duration of mechanical ventilation.

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Adolescents Hospitalized with SARS-CoV-2: Analysis of Clinical Profile and Risk Factors for Severe Disease over a two-year period

10.1101/2022.01.06.22268674 ◽

2022 ◽

Author(s):

Tamoghna Ghosh ◽

Tejas M Suri ◽

Kana Ram Jat ◽

Aditya Kumar Gupta ◽

Sushma Bhatnagar ◽

...

Keyword(s):

Risk Factors ◽

Severe Disease ◽

Tertiary Hospital ◽

Clinical Profile ◽

North India ◽

Mild Disease ◽

Reactive Protein ◽

Northern India ◽

Severity Grading ◽

Second Wave

Introduction: There is a lack of studies in adolescents with COVID-19 from developing countries. We aimed to describe the clinical profile and risk factors for severe disease in adolescents hospitalized with COVID-19. Methods: A retrospective analysis of a prospectively admitted cohort of COVID-19 patients was performed at a tertiary hospital in north India. Adolescents aged 12 to 18 years who were hospitalized during the first wave (March 2020 to December 2020) and the second wave (March 2021 to June 2021) of the pandemic were included. Data on the demographic details, clinical presentation, laboratory parameters, disease severity at admission, treatments received, and in-hospital outcomes were retrieved and logistic regression was used to identify the risk factors for occurrence of moderate or severe disease. Results: The study included 197 adolescents with median (IQR) age 15 (13-17) years, of whom 117 (59.4%) were male. Among these, 170 (86.3%) were admitted during the 1st wave. Underlying comorbidities were present in 9 (4.6%) patients. At the time of hospital admission, 60 (30.9%) patients were asymptomatic. In the severity grading, 148 (84.6%) had mild, 16 (9.1%) had moderate, and 11 (6.3%) had severe disease. Fever (14.9%) and cough (14.9%) were the most commonly encountered symptoms. The median (IQR) duration of hospital stay was 10 (8-13) days and 6 (3.1%) patients died in hospital. The odds of moderate to severe disease were 3.8 for second wave, 1.9 for fever and 1.1 for raised C reactive protein (CRP). Conclusion: In our single-center study from northern India, adolescents admitted with COVID-19 had predominantly asymptomatic or mild disease. Admission during the second wave of COVID-19 pandemic, presence of fever and raised CRP were risk factors for moderate or severe disease.

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Premorbid Echocardiography And Risk of Hospitalization In COVID-19

10.21203/rs.3.rs-1236645/v1 ◽

2022 ◽

Author(s):

Harsh Goel ◽

Kashyap Shah ◽

Janish Kothari ◽

Timothy Daly ◽

Pooja Saraiya ◽

...

Keyword(s):

Risk Factors ◽

Left Atrial ◽

Severe Disease ◽

Vaccine Hesitancy ◽

Hospital Death ◽

Rt Pcr ◽

Mild Disease ◽

Global Pandemic ◽

Artery Disease

Abstract Background: COVID-19 has caused an unprecedented global pandemic, with cardiovascular risk factors predicting outcomes. We investigated whether baseline trans-thoracic echocardiography could refine risk beyond clinical risk factors. Methods: Symptomatic COVID-19 positive (RT-PCR) adults across St Luke’s University Health Network between March 1st-October 31st 2021, with trans-thoracic echocardiography (TTE) within 15-180 days preceding COVID-19 positivity were selected. Demographic/clinical/echocardiographic variables were extracted from patients’ EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization. Results: 192 patients were included. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in moderate-severe versus mild disease. On multivariate analysis, age (OR 1.039, 95% CI 1.011-1.067), coronary artery disease (OR 4.184, 95% CI 1.451-12.063), COPD (OR 6.886, 95% CI 1.396-33.959) and left atrial (LA) diameter ≥4.0cm (OR 2.379, 95% CI 1.031-5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746-0.873). Conclusion: Baseline LA enlargement independently predicts risk of hospitalization in COVID-19. When available, baseline LA enlargement could identify patients for 1) closer outpatient follow-up, and 2) counseling vaccine-hesitancy.

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Perbandingan Nilai PETCO2 dan PACO2 pada Pasien dengan Pemasangan Ventilasi Mekanik

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v4i1.134 ◽

1970 ◽

Vol 4 (1) ◽

Author(s):

Baskoro Soetioputro ◽

F. Sri Susilaningsih ◽

Titin Mulyati

Keyword(s):

Mechanical Ventilation ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Regulation Of Respiration ◽

Blood Gas ◽

Altman Plot ◽

Cross Sectional ◽

Bland Altman Plot ◽

Consecutive Sampling ◽

Arterial Blood

Pasien dengan ventilasi mekanik perlu dilakukan pemantauan CO2 karena berperan penting pada regulasi pernapasan dan keseimbangan asam-basa tubuh. Pemantauan CO2 dapat dilakukan dengan mengukur PaCO2 melalui analisis gas darah arteri. Pengukuran PaCO2 tidak dapat dilakukan secara kontinu sehingga perlu sering dilakukan pengambilan darah arteri yang dapat menimbulkan komplikasi. Pengukuran PETCO2 dapat memantau CO2 secara kontinu dan non invasif. PETCO2 adalah tekanan parsial CO2 ekspirasi yang diukur pada saat akhir volume tidal pernapasan. Penelitian ini bertujuan membandingkan nilai PETCO2 dan PaCO2 pada pasien dengan ventilasi mekanik di ruang GICU RSUP Dr. Hasan Sadikin Bandung. Rancangan penelitian yang digunakan adalah prospective cross sectional. Pemilihan sampel dilakukan secara consecutive sampling. Penelitian dilakukan terhadap 21 pasien yang menggunakan ventilasi mekanik di ruang GICU RSUP Dr. Hasan Sadikin Bandung. Data PETCO2 dicatat pada saat perawat mengambil sampel darah arteri untuk pemeriksaan analisis gas darah. Didapatkan 122 pasang data nilai PETCO2 dan PaCO2. Data yang diperoleh dianalisis dengan Bland-Altman plot. Hasil penelitian nilai PETCO2 berada pada rentang 14-67 mmHg dan nilai PaCO2 berada pada rentang 17-77 mmHg. Bias nilai PETCO2 dan PaCO2 adalah -4,6475 mmHg lebih rendah daripada estimasi nilai bias ±5 mmHg sehingga bisa diterima secara klinik. Presisi nilai PETCO2 adalah 12,7969 mmHg (limit of agreement= 1,7509; -11,0460) lebih tinggi daripada estimasi nilai presisi ±5 mmHg sehingga tidak bisa diterima secara klinik. Kesimpulan dari penelitian ini adalah pengukuran PETCO2 tidak dapat menggantikan pengukuran PaCO2, tetapi pengukuran PETCO2 dapat digunakan untuk memperkirakan nilai PaCO2 pasien dengan ventilasi mekanik.Kata kunci: PETCO2, PaCO2, ventilasi mekanik. Comparison of PETCO2 and PACO2 Values in Patients with Mechanical VentilationAbstractPatients with mechanical ventilation need to be monitored for the CO2 value because it has an important role in regulation of respiration and body acid-base equilibrium. Monitoring of CO2 can be done by measuring PaCO2 through arterial blood gas analysis. Measurement of PaCO2 could not be done continuously so that the arterial blood are needed to be taken quite often which could cause complication. The measurement of PETCO2 can monitor the CO2 continuously and non-invasively. PETCO2 is partial pressure of CO2 expiration that is measured at the end of respiration tidal volume. This study aimed to compare the PETCO2 value and PaCO2 in patients with mechanical ventilation in GICU Dr. Hasan Sadikin Hospital. The research design was prospective cross-sectional using consecutive sampling method. The total sample was 21 patients who used mechanical ventilator in GICU Dr. Hasan Sadikin Hospital Bandung. The PETCO2 data were recorded when the patients’ arterial blood sample were taken for blood gas analysis test. The total of 122 pair date of PETCO2 and PaCO2 values were recorded. The data were analyzed using Bland-Altman plot. The results showed that the PETCO2 value ranged from 14 – 67 mmHg and the PaCO2 values ranged from 17 – 77 mmHg. The deviation of PETCO2 and PaCo2 was -4.6475 mmHg, which is lower than the estimation of ± 5 mmHg deviation, therefore the PETCO2 measurement can be accepted clinically. The precision of PETCO2 was 12.7969 mmHg (limit of agreement = 1.7509; -11.0460) which is higher than the estimation of precision value of ±5 mmHg, therefore it cannot be accepted clinically. In conclusion, the PETCO2 measurement could not replace the PaCO2 measurement, however, PETCO2 measurement can be used to predict the value of PaCO2 for patients with mechanical ventilation.Keywords: Mechanical ventilation, PETCO2, PaCO2.

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Risk factors for clinical progression in patients with COVID-19: a retrospective study of electronic health record data in the United Kingdom

10.1101/2020.05.11.20093096 ◽

2020 ◽

Cited By ~ 3

Author(s):

Robert A Fletcher ◽

Thomas Matcham ◽

Marta Tibúrcio ◽

Arseni Anisimovich ◽

Stojan Jovanović ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Logistic Regression ◽

Body Temperature ◽

Blood Cell ◽

Severe Disease ◽

C Reactive Protein ◽

Reactive Protein ◽

Multivariable Logistic Regression ◽

D Dimer

Background: The novel coronavirus disease 2019 (COVID-19) outbreak presents a significant threat to global health. A better understanding of patient clinical profiles is essential to drive efficient and timely health service strategies. In this study, we aimed to identify risk factors for a higher susceptibility to symptomatic presentation with COVID-19 and a transition to severe disease. Methods: We analysed data on 2756 patients admitted to Chelsea & Westminster Hospital NHS Foundation Trust between 1st January and 23rd April 2020. We compared differences in characteristics between patients designated positive for COVID-19 and patients designated negative on hospitalisation and derived a multivariable logistic regression model to identify risk factors for predicting risk of symptomatic COVID-19. For patients with COVID-19, we used univariable and multivariable logistic regression to identify risk factors associated with progression to severe disease defined by: 1) admission to the hospital AICU, 2) the need for mechanical ventilation, 3) in-hospital mortality, and 4) at least one measurement of elevated D-dimer (equal or superior to 1,000 ug/L) indicative of increased risk of venous thromboembolism. Results: The patient population consisted of 1148 COVID-19 positive and 1608 COVID-19 negative patients. Age, sex, self-reported ethnicity, C-reactive protein, white blood cell count, respiratory rate, body temperature, and systolic blood pressure formed the most parsimonious model for predicting risk of symptomatic COVID-19 at hospital admission. Among 1148 patients with COVID-19, 116 (10.1%) were admitted to the AICU, 71 (6.2%) required mechanical ventilation, 368 (32.1%) had at least one record of D-dimer levels ≥1,000 μg/L, and 118 patients died. In the multivariable logistic regression, age (OR = 0.953 per 1 year, 95% CI: 0.937-0.968) C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.007), and white blood cell counts (OR = 1.059 per 109/L, 95% CI: 1.010-1.111) were found to be associated with admission to the AICU. Age (OR = 0.973 per 1 year, 95% CI: 0.955-0.990), C-reactive protein (OR = 1.003 per 1 mg/L, 95% CI: 1.000-1.006) and sodium (OR = 0.915 per 1 mmol/L, 0.868-0.962) were associated with mechanical ventilation. Age (OR = 1.023 per 1 year, 95% CI: 1.004-1.043), CRP (OR = 1.004 per 1 mg/L, 95% CI: 1.002-1.006), and body temperature (OR = 0.723 per 1oC, 95% CI: 0.541-0.958) were associated with elevated D-dimer. For mortality, we observed associations with age (OR = 1.060 per 1 year, 95% CI: 1.040-1.082), female sex (OR = 0.442, 95% CI: 0.442, 95% CI: 0.245-0.777), Asian ethnic background (OR = 2.237 vs White ethnic background, 95% CI: 1.111-4.510), C-reactive protein (OR = 1.004 per 1 mg/L, 95% CI: 1.001-1.006), sodium (OR = 1.038 per 1 mmol/L, 95% CI: 1.001-1.006), and respiratory rate (OR = 1.054 per 1 breath/min, 95% CI: 1.024-1.087). Conclusion: Our analysis suggests there are several demographic, clinical and laboratory findings associated with a symptomatic presentation of COVID-19. Moreover, significant associations between patient deterioration were found with age, sex and specific blood markers, chiefly C-reactive protein, and could help early identification of patients at risk of poorer prognosis. Further work is required to clarify the extent to which our observations are relevant beyond current settings.

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