Daniel Munblit1,2,3, Nikita A Nekliudov1, Polina Bugaeva1, Oleg Blyuss1,4, Maria Kislova1, Ekaterina Listovskaya1, Aysylu Gamirova1, Anastasia Shikhaleva1, Vladimir Belyaev5, Peter Timashev6,7,8, John O Warner2, Pasquale Comberiati9, Christian Apfelbacher10, Evgenii Bezrukov11, Mikhail E Politov12, Andrey Yavorovskiy12, Ekaterina Bulanova12, Natalya Tsareva13, Sergey Avdeev13, Valentina A Kapustina14, Yuri I Pigolkin15, Emmanuelle A Dankwa16, Christiana Kartsonaki17, Mark G Pritchard18,19, Victor Fomin20, Andrey A Svistunov20, Denis Butnaru20, Petr Glybochko20. 1. Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 2. Inflammation, Repair, and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom. 3. Soloviev Research and Clinical Center for Neuropsychiatry, Moscow, Russia. 4. School of Physics, Astronomy, and Mathematics, University of Hertfordshire, Hatfield, United Kingdom. 5. Biobank, Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 6. Institute for Regenerative Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 7. Chemistry Department, Lomonosov Moscow State University, Moscow, Russia. 8. Department of Polymers and Composites, N. N. Semenov Institute of Chemical Physics, Moscow, Russia. 9. Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy. 10. Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany. 11. Institute for Urology and Reproductive Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 12. Department of Intensive Care, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 13. Clinic of Pulmonology, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 14. Department of Internal Medicine No. 1, Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 15. Department of Forensic Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia. 16. Department of Statistics, University of Oxford, Oxford, United Kingdom. 17. Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. 18. Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom. 19. Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom. 20. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Abstract
BACKGROUND: The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking. METHODS: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19 infection in Moscow between 8 April and 28 May 2020. RESULTS: Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47). CONCLUSIONS: Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19 infection, indicating that laboratory testing is not critical in real-life clinical practice.
BACKGROUND: The epidemiology, clinical course, and outcomes of patients with coronavirus disease 2019 (COVID-19) in the Russian population are unknown. Information on the differences between laboratory-confirmed and clinically diagnosed COVID-19 in real-life settings is lacking. METHODS: We extracted data from the medical records of adult patients who were consecutively admitted for suspected COVID-19infection in Moscow between 8 April and 28 May 2020. RESULTS: Of the 4261 patients hospitalized for suspected COVID-19, outcomes were available for 3480 patients (median age, 56 years; interquartile range, 45-66). The most common comorbidities were hypertension, obesity, chronic cardiovascular disease, and diabetes. Half of the patients (n = 1728) had a positive reverse transcriptase-polymerase chain reaction (RT-PCR), while 1748 had a negative RT-PCR but had clinical symptoms and characteristic computed tomography signs suggestive of COVID-19. No significant differences in frequency of symptoms, laboratory test results, and risk factors for in-hospital mortality were found between those exclusively clinically diagnosed or with positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR. In a multivariable logistic regression model the following were associated with in-hospital mortality: older age (per 1-year increase; odds ratio, 1.05; 95% confidence interval, 1.03-1.06), male sex (1.71; 1.24-2.37), chronic kidney disease (2.99; 1.89-4.64), diabetes (2.1; 1.46-2.99), chronic cardiovascular disease (1.78; 1.24-2.57), and dementia (2.73; 1.34-5.47). CONCLUSIONS:Age, male sex, and chronic comorbidities were risk factors for in-hospital mortality. The combination of clinical features was sufficient to diagnose COVID-19infection, indicating that laboratory testing is not critical in real-life clinical practice.
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