Outcome of Non-Critical COVID-19 Patients with Early Hospitalization and Early Antiviral Treatment Outside the ICU

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Turk J Med Sci. 2020 Jul 28. doi: 10.3906/sag-2006-173. Online ahead of print.


Background Despite the COVID-19 pandemic has been going on over 5 months, there is yet to be a standart management policy for all patients including to those mild-to-moderate cases. We evaluated the role of a combined effort of early hospitalization in combination with early antiviral therapy with COVID-19 patients in a tertiary care university hospital. Materials and Methods This was a prospective, observational, single center study on probable/confirmed COVID-19 patients hospitalized in a tertiary care hospital COVID-19 wards between March 20- April 30, 2020. Critically-ill patients requiring intensive care unit (ICU) at the time of admission were excluded. The demographic, laboratory, and clinical data were collected. Results We included 174 consecutive probable/confirmed COVID-19 adult patients hospitalized in the Internal Medicine wards of the University Adult Hospital between March 20 and April 30, 2020. The median age was 45.5 (19-92) years and 91 patients (52.3% ) were male. 120 (69%) were confirmed microbiologically, 41 (23.5%) radiologically diagnosed and, 13 (7.5%) were clinically suspected (negative microbiological and radiological findings compatible with COVID-19). According to WHO definitions, 35 (20.1%) had mild, 107 (61.5%) moderate disease, and 32 (18.4%) had severe pneumonia. Of 130/171 ( 74.3%) showed pneumonia; 80 were typical, 50 indeterminate infiltration for COVID-19. Patients admitted within a median of 3 days (0-14 days) after symptoms appear. The median duration of hospitalization was 4 days (0 - 28 days). In this case series, 13.2% patients were treated with hydroxychloroquine alone, 64.9% with hydroxychloroquine plus azithromycin, and 18.4% with regimens including favipiravir. A total of 15 patients (8.5%) were transferred to the ICU. Four patients died (2.2%). Conclusion In our series, early of 174 patients admitted to the hospital wards for COVID-19, 69% confirmed with PCR and/or antibody test. On the admission nearly one fifth of the patients had severe diseases. 95.4% of the patients received HQ alone or in combination. The overall case fatality rate was 2.2%.

PMID:32718127 | DOI:10.3906/sag-2006-173

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