UNVEILING THE PROGNOSTIC POWER OF EARLY SYMPTOMOLOGY IN MODERATE TO SEVERE FORMS OF COVID-19 DISEASE

  • Branko Beronja Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Olja Stevanović Clinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
  • Nataša Nikolić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
  • Nevena Todorović Clinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
  • Ana Filipović Clinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
  • Jelena Simić Clinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
  • Tatjana Gazibara Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Jelena Dotlić Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, Belgrade, Serbia
  • Biljana Lukić General Hospital "Dr Radivoj Simonović", Sombor, Serbia
  • Aleksandra Karan General Hospital "Dr Radivoj Simonović", Sombor, Serbia
  • Ivana Milošević Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Infectious and Tropical Diseases, University Clinical Centre of Serbia, Belgrade, Serbia
Keywords: COVID-19, prognosis, intensive care unit, fatal outcome, symptoms

Abstract


Introduction: It is not entirely clear what initial symptoms could predict poorer COVID-19 outcomes. The purpose of this study was to identify the initial COVID-19 symptoms associated with the need for an intensive care unit (ICU) treatment and having fatal outcomes of COVID-19.

Methods: A retrospective analysis was conducted on patients who were hospitalized in two health care facilities (in Belgrade and Sombor) from March 2021 to April 2022. Data were collected from the electronic medical records. The main outcomes were treatment in the ICU and ICU mortality. The Cox proportional hazard model was used to identify the initial COVID-19 symptoms associated with the ICU treatment and mortality.

Results: This research included 457 patients. The average age of patients was 63.77±13.75 years. The most common initial symptoms of COVID-19 were fever (85.1%), cough (77.2%), and fatigue (54.5%). The least common initial symptoms were hoarseness (2.8%), difficulty swallowing (2.8%), and eye itching (1.7%). The adjusted model showed that being older and having chest pain were independently associated with needing the ICU treatment. Furthermore, being older, having shortness of breath, headache and diarrhea, but absence of nasal congestion, were independently associated with poorer survival.

Conclusion: The results of this study emphasize the importance of vigilant monitoring and swift intervention in patients presenting with chest pain, shortness of breath, headache, and diarrhea, particularly among older people.

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Published
2024/04/26
Section
ORIGINAL ARTICLE