Clinical Microbiology and Infection ( IF 10.9 ) Pub Date : 2021-09-03 , DOI: 10.1016/j.cmi.2021.08.021 Aurélien Dinh 1 , Luc Jaulmes 2 , Agnès Dechartres 3 , Clara Duran 4 , Hélène Mascitti 4 , Xavier Lescure 5 , Youri Yordanov 6 , Patrick Jourdain 7 , , , ,
Objectives
To assess the time to resolution of respiratory and systemic symptoms and their associated factors in outpatients during the coronavirus disease 2019 (COVID-19) pandemic.
Methods
Cohort study including adult outpatients, managed with Covidom, a telesurveillance solution, with RT-PCR-confirmed diagnosis, from 9 March 2020 until 23 February 2021. Follow up was 30 days after symptom onset.
Results
Among the 9667 patients included, mean age was 43.2 ± 14.0 years, and 67.5% were female (n = 6522). Median body mass index (BMI) was 25.0 kg/m2 (interquartile range 22.1–28.8 kg/m2). Main co-morbidities were: hypertension (12.9%; n = 1247), asthma (11.0%; n = 1063) and diabetes mellitus (5.5%; n = 527). The most frequent symptom during follow up was dyspnoea (65.1%; n = 6296), followed by tachypnoea (49.9%; n = 4821), shivers (45.6%; n = 4410) and fever (36.7%; n = 3550). Median times to resolution of systemic and respiratory symptoms were 3 days (95% CI 2−4 days) and 7 days (95% CI 6−8 days), respectively. Ultimately, 17.2% (95% CI 15.7%−18.8%) still presented respiratory symptoms at day 30. Longer time to respiratory symptom resolution was associated with older age, increased BMI, chronic obstructive pulmonary disease, coronary artery disease, asthma and heart failure. Regarding systemic symptoms, coronary artery disease, asthma, age above 40 years and elevated BMI were associated with longer time to resolution.
Conclusions
Time to symptom resolution among outpatients with COVID-19 seemed shorter for systemic than respiratory symptoms. Prolonged respiratory symptoms were common at day 30. Risk factors associated with later resolution included age, and cardiovascular and pulmonary diseases.
中文翻译:
在社区环境中解决呼吸道和全身性冠状病毒病 2019 症状的时间
目标
评估在 2019 年冠状病毒病 (COVID-19) 大流行期间门诊患者呼吸和全身症状及其相关因素的缓解时间。
方法
从 2020 年 3 月 9 日至 2021 年 2 月 23 日,队列研究包括成人门诊患者,使用 Covidom(一种远程监控解决方案)进行管理,并具有 RT-PCR 确认的诊断。随访时间为症状出现后 30 天。
结果
在纳入的 9667 名患者中,平均年龄为 43.2±14.0 岁,67.5% 为女性(n = 6522)。中位体重指数 (BMI) 为 25.0 kg/m 2(四分位距 22.1–28.8 kg/m 2)。主要合并症为:高血压(12.9%;n = 1247)、哮喘(11.0%;n = 1063)和糖尿病(5.5%;n = 527)。随访期间最常见的症状是呼吸困难 (65.1%; n = 6296),其次是呼吸急促 (49.9%; n = 4821)、寒战 (45.6%; n = 4410) 和发烧 (36.7%; n = 3550)。全身和呼吸道症状消退的中位时间分别为 3 天(95% CI 2-4 天)和 7 天(95% CI 6-8 天)。最终,17.2% (95% CI 15.7%−18.8%) 在第 30 天仍然出现呼吸道症状。 呼吸道症状消退的时间更长与年龄较大、BMI 增加、慢性阻塞性肺疾病、冠状动脉疾病、哮喘和心力衰竭有关. 关于全身症状,冠状动脉疾病、哮喘、年龄超过 40 岁和 BMI 升高与更长的消退时间相关。
结论
在 COVID-19 门诊患者中,全身症状的缓解时间似乎比呼吸道症状要短。长期呼吸道症状在第 30 天很常见。与后来消退相关的危险因素包括年龄、心血管和肺部疾病。