Saldías Peñafiel Fernando, Peñaloza Tapia Alejandro, Farías Nesvadba Daniela, Farcas Oksenberg Katia, Reyes Sánchez Antonia, Cortés Meza Josefina, Lara Hernández Bárbara, Aguilera Fuenzalida Pablo, Leiva Rodríguez Isabel
Departamento de Enfermedades Respiratorias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Sección de Medicina de Urgencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2020 Oct;148(10):1387-1397. doi: 10.4067/S0034-98872020001001387.
In December 2019, coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world.
To describe the clinical features, risk factors, and predictors of hospitalization in adult patients treated for acute respiratory infections associated with coronavirus SARS-CoV-2.
Descriptive prospective study of ambulatory and hospitalized adult patients with confirmed COVID-19 attended between April 1 and May 31, 2020. Clinical features, chronic comorbidities and demographic data were recorded, and patients were followed for two months as outpatients.
We assessed 1,022 adults aged 41 ± 14 years (50% men) with laboratory-confirmed COVID-19. One-third had comorbidities, specially hypertension (12.5%), hypothyroidism (6.6%), asthma (5.4%) and diabetes (4.5%). Hospital admission was required in 11%, 5.2% were admitted to critical care unit and 0.9% were connected to mechanical ventilation. Common symptoms included fatigue (55.4%), fever (52.5%), headache (68.6%), anosmia/dysgeusia (53.2%), dry cough (53.4%), dyspnea (27.4%) and diarrhea (35.5%). One third of patients reported persistence of symptoms at one-month follow-up, specially fatigue, cough and dyspnea. In the multivariate analysis, age, fever, cough, dyspnea and immunosuppression were associated with hospitalization and ICU admission. Age, male sex and moderate-severe dyspnea were associated with requirement of mechanical ventilation. The main predictors of prolonged clinical course were female sex, presence of comorbidities, history of dyspnea, cough, myalgia and abdominal pain.
Clinical features of COVID-19 were highly unspecific. Prediction models for severity, will help medical decision making at the primary care setting.
2019年12月，新型冠状病毒肺炎（COVID-19）在武汉市出现，并迅速在中国乃至全球传播。
描述成人急性呼吸道感染新型冠状病毒SARS-CoV-2患者的临床特征、危险因素及住院预测因素。
对2020年4月1日至5月31日期间确诊为COVID-19的门诊和住院成年患者进行描述性前瞻性研究。记录临床特征、慢性合并症和人口统计学数据，并将患者作为门诊患者随访两个月。
我们评估了1022名年龄为41±14岁（50%为男性）、实验室确诊为COVID-19的成年人。三分之一的患者有合并症，特别是高血压（12.5%）、甲状腺功能减退（6.6%）、哮喘（5.4%）和糖尿病（4.5%）。11%的患者需要住院治疗，5.2%的患者入住重症监护病房，0.9%的患者接受机械通气。常见症状包括疲劳（55.4%）、发热（52.5%）、头痛（68.6%）、嗅觉减退/味觉障碍（53.2%）、干咳（53.4%）、呼吸困难（27.4%）和腹泻（35.5%）。三分之一的患者在1个月随访时报告症状持续存在，特别是疲劳、咳嗽和呼吸困难。多因素分析显示，年龄、发热、咳嗽、呼吸困难和免疫抑制与住院和入住重症监护病房相关。年龄、男性性别和中度至重度呼吸困难与机械通气需求相关。临床病程延长的主要预测因素为女性性别、合并症的存在、呼吸困难史、咳嗽、肌痛和腹痛。
COVID-19的临床特征高度不特异。严重程度预测模型将有助于基层医疗环境中的医疗决策。
