tetano
Editor, Senior Moderator
J Med Virol
. 2021 Aug 4.
doi: 10.1002/jmv.27253. Online ahead of print.
Prolonged Symptom Onset to Admission Time is Associated with Severe Coronavirus Disease: A Meta combined Propensity-adjusted Analysis
Yingchao Guan[SUP] 1 [/SUP], Chaojin Chen[SUP] 1 [/SUP], Anping Guo[SUP] 2 [/SUP], Jingru Wei[SUP] 1 [/SUP], Jiahui Cai[SUP] 3 [/SUP], Hua Han[SUP] 4 [/SUP], Ziqing Hei[SUP] 1 [/SUP], Haizhu Tan[SUP] 3 [/SUP], Xiaoyun Li[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Patients with severe COVID-19 are more likely to develop adverse outcomes with huge medical burden. We aimed to investigate whether a shorter symptom onset to admission time (SOAT) could improve outcomes of COVID-19 patients.
Methods: A single-centre retrospective study combined with a meta-analysis was performed. The meta-analysis identified studies published between 1 December 2019 and 15 April 2020. Additionally, clinical data of COVID-19 patients diagnosed between January 20 and February 20, 2020 at the First Affiliated Hospital of the University of Science and Technology of China were retrospectively analyzed. SOAT and severity of illness in patients with COVID-19 were used as effect measures. Random effects model was used to analyze the heterogeneity across studies. Propensity score matching was applied to adjust for confounding factors in the retrospective study. Categorical data were compared using the Fisher's exact test. We compared the differences in laboratory characteristic vary times using a two-way nonparametric, Scheirer-Ray-Hare test.
Results: In meta-analysis, we found patients with adverse outcomes had a longer SOAT (I[SUP]2[/SUP] =39%, mean difference 0.88, 95% confidence interval=0.47-1.30). After adjusting for confounding factors such as age, complications and treatment options, the retrospective analysis results also showed that severe patients had longer SOAT (mean difference 1.13 [1.00, 1.27], P = 0.046). Besides, most biochemical marker levels improved as the hospitalization time lengthened without effect of disease severity or associated treatment(P<0·001).
Conclusion: Shortening the SOAT may help reduce the possibility of mild patients with COVID-19 progressing to severe illness. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Critical Care Outcomes; Meta-Analysis; Prognosis; Retrospective Study.
. 2021 Aug 4.
doi: 10.1002/jmv.27253. Online ahead of print.
Prolonged Symptom Onset to Admission Time is Associated with Severe Coronavirus Disease: A Meta combined Propensity-adjusted Analysis
Yingchao Guan[SUP] 1 [/SUP], Chaojin Chen[SUP] 1 [/SUP], Anping Guo[SUP] 2 [/SUP], Jingru Wei[SUP] 1 [/SUP], Jiahui Cai[SUP] 3 [/SUP], Hua Han[SUP] 4 [/SUP], Ziqing Hei[SUP] 1 [/SUP], Haizhu Tan[SUP] 3 [/SUP], Xiaoyun Li[SUP] 1 [/SUP]
Affiliations
- PMID: 34347302
- DOI: 10.1002/jmv.27253
Abstract
Background: Patients with severe COVID-19 are more likely to develop adverse outcomes with huge medical burden. We aimed to investigate whether a shorter symptom onset to admission time (SOAT) could improve outcomes of COVID-19 patients.
Methods: A single-centre retrospective study combined with a meta-analysis was performed. The meta-analysis identified studies published between 1 December 2019 and 15 April 2020. Additionally, clinical data of COVID-19 patients diagnosed between January 20 and February 20, 2020 at the First Affiliated Hospital of the University of Science and Technology of China were retrospectively analyzed. SOAT and severity of illness in patients with COVID-19 were used as effect measures. Random effects model was used to analyze the heterogeneity across studies. Propensity score matching was applied to adjust for confounding factors in the retrospective study. Categorical data were compared using the Fisher's exact test. We compared the differences in laboratory characteristic vary times using a two-way nonparametric, Scheirer-Ray-Hare test.
Results: In meta-analysis, we found patients with adverse outcomes had a longer SOAT (I[SUP]2[/SUP] =39%, mean difference 0.88, 95% confidence interval=0.47-1.30). After adjusting for confounding factors such as age, complications and treatment options, the retrospective analysis results also showed that severe patients had longer SOAT (mean difference 1.13 [1.00, 1.27], P = 0.046). Besides, most biochemical marker levels improved as the hospitalization time lengthened without effect of disease severity or associated treatment(P<0·001).
Conclusion: Shortening the SOAT may help reduce the possibility of mild patients with COVID-19 progressing to severe illness. This article is protected by copyright. All rights reserved.
Keywords: COVID-19; Critical Care Outcomes; Meta-Analysis; Prognosis; Retrospective Study.