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Factors Associated with Prompt Recovery among Hospitalized Patients with Coronavirus Disease 2019
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  • Pamela Ny,
  • Corey Kelsom,
  • Amanda Chron,
  • Mimi Lou,
  • Paul Nieberg,
  • Kimberly Shriner,
  • Holly Huse,
  • Annie Wong-Beringer
Pamela Ny
Huntington Memorial Hospital
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Corey Kelsom
Huntington Memorial Hospital
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Amanda Chron
University of Southern California
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Mimi Lou
University of Southern California
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Paul Nieberg
Huntington Memorial Hospital
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Kimberly Shriner
Huntington Memorial Hospital
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Holly Huse
Huntington Memorial Hospital
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Annie Wong-Beringer
Huntington Memorial Hospital
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Abstract

Background: Patients who survived hospitalization for COVID-19 experienced varying durations of illness but the factors associated with prompt recovery are unknown. This study identifies factors differentiating hospitalized patients who recovered promptly vs. survived a prolonged course of illness due to COVID-19. Methods: This was a retrospective study from March-August 2020 of hospitalized adults with COVID-19 which were grouped based on time to recovery: short (≤ 3 days), intermediate (4-10 days), and prolonged (>10 days). Recovery was defined as resolution of fever, tachypnea, hypotension, extubation and return of mental status at baseline. Multivariate analysis was used to evaluate factors associated with prompt recovery. Results: Among 508 patients hospitalized for COVID-19, 401 (79%) survived. Of those, prompt recovery (within 3 days) was achieved in 43% (174/401) whereas 23% (92/401) recovered after a prolonged period of > 10 days. Overall, median age was 64 y with 73% admitted from home and 25% from a skilled nursing facility. Predictors for prompt recovery upon admission included female sex (OR, 1.8; 95% CI, 1.1-2.7; p = 0.01), no fever (OR, 1.6; 95% CI, 1.1-2.6; p = 0.03), longer time from symptom onset to hospitalization (OR, 1.1; 95% CI, 1.0-1.1; p = 0.001), no supplemental oxygen (OR, 1.9; 95% CI, 1.2-3.0; p = 0.004), no direct ICU admission (OR, 41.7; 95% CI, 2.4-740.4; p = 0.01) and absence of bacterial co-infections (OR, 2.5; 95% CI, 1.5-4.0, p = 0.0003). Conclusions: Our study provides relevant data that could help clinicians triage competing resources in health systems that are challenged by the ebb and flow of COVID-19 cases by identifying clinical features of COVID-19 patients who may require less intensive management including avoidance of unnecessary antibacterial therapy.

Peer review status:UNDER REVIEW

24 Feb 2021Submitted to International Journal of Clinical Practice
25 Feb 2021Assigned to Editor
25 Feb 2021Submission Checks Completed
28 Feb 2021Reviewer(s) Assigned