C. Thibeault, Barbara Mühlemann, E. T. Helbig, M. Mittermaier, T. Lingscheid, P. Tober-Lau, L. Meyer-Arndt, Leonie Meiners, P. Stubbemann, S. Haenel, L. Bosquillon de Jarcy, L. Lippert, M. Pfeiffer, M. Stegemann, R. Roehle, Janine Wiebach, S. Hippenstiel, T. Zoller, H. Müller-Redetzky, A. Uhrig, F. Balzer, C. von Kalle, N. Suttorp, T. Jones, C. Drosten, M. Witzenrath, L. Sander, Linda Malte Sophy Christoph Bettina Katrin M. Dirk Andre Jürgens Kleinschmidt Denker Ruwwe-Glösenkamp Temme, L. Jürgens, M. Kleinschmidt, S. Denker, C. Ruwwe-Glösenkamp, B. Temmesfeld-Wollbrück, K. Heim, D. Schürmann, A. Hocke, B. Opitz, Belén Millet Pascual-Leone, R. Schuhmacher, N. Olk, D. Hillus, F. Machleidt, Sebastian Albus, F. Bremer, Jan-Moritz Doehn, Carmen García, P. Knape, P. Krause, Liron Lechtenberg, Yaosi Li, Panagiotis Pergantis, Teresa Ritter, Berna Yedikat, Christian Zobel, Friederike Hefele, Ute Kellermann, M. Schürmann, Lisa-Marie Wackernagel, Anne Wetzel, D. Grund, J. Haumesser, Johannes Hodes, J. Rein, Peter Radünzel, A. Breitbart, Sergej Münzenberg, D. Soll, Tamar Zhamurashvili, R. Hübner, F. Alius, T. Andermann, T. Cronen, S. Fraumann, N. Frost, D. Geus, Gisele J. Godzick-Njomgang, Anne Herholz, V. Hermanns, Moritz Hilbrandt, T. Jacobi, Ye-ji Kim, Elena Madlung, Luise Martin, N. Menner, A. Mikołajewska, Luisa Mrziglod, Nadine Muller, Michaela Niebank, E. Pappe, F. Pfäfflin, Lennart Pfannkuch, M. Raspe, N. Reck, A. Ritter, J. Saccomanno, L. Schmalbrock, F. Steinbeis, C. Tabeling, Markus Vogtmann, S. Weber, Markus C. Brack, M. Felten, S. Schmidt, M. Rönnefarth, Georg Schwanitz, A. Krannich, Saskia Zvorc, Uwe D. Behrens, L. Kretzler, Linna Li, I. Wirsching, C. Dang-Heine, M. Hummel, D. Briesemeister, D. Treue, M. Möckel, S. Knauss, M. Endres, C. Spies, S. Weber-Carstens, J. Kruse, D. Zickler, Andreas Edel, B. Stier, P. Enghard, R. Körner, K. Eckardt, Lucas Elbert, Christopher P Neumann, Marius A. Eckart, T. N. Pham, S. Schönberger, A. Wree, F. Tacke, Josef Mang, Nadia de Vries, M. Wittenberg, Jana Riecke, Julia Heeschen, S. Treskatsch, S. Angermair, P. van Dijck, V. Corman, F. Kurth
Infection, 2021
Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. The purpose of this work was to identify risk factors associated with need for invasive mechanical ventilation (IMV), to analyse viral kinetics in patients with and without IMV and to provide a comprehensive description of clinical course. A cohort of 168 hospitalised adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care centre was analysed. Forty-four per cent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95% CI 1.10–1.37, p < 0.01) and history of hypertension (aOR 5.55, 95% CI 2.00–16.82, p < 0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26–46.75, vs 18 days, IQR 16–46.75, respectively, p < 0.01). Median duration of hospitalisation was 9 days (IQR 6–15.5) for non-IMV and 49.5 days (IQR 36.8–82.5) for IMV patients. Our results indicate a short duration of symptoms before admission as a risk factor for severe disease that merits further investigation and different viral load kinetics in severely affected patients. Median duration of hospitalisation of IMV patients was longer than described for acute respiratory distress syndrome unrelated to COVID-19.
Cited by 4 publications.
Field of study: Medicine