ASSOCIATION OF CLINICAL PRESENTATION WITH SEVERITY AND OUTCOME OF COVID-19

Abstract

Background. The world continues to struggle with the 2019 coronavirus disease (COVID-19). The pandemic is under control, but the disease exists and it is extremely important to have algorithms for early diagnostic and prognostic guidance. The aim of the study is to find correlations between the spectrum of clinical symptoms with the disease severity and the outcome of COVID-19, aiming to maximally early diagnosis and establishing early predictors for severity and fatal outcome. Materials and methods. The study included 169 adults hospitalized at the University Hospital St. George, Plovdiv, between September 2021 and December 2022 with a PCR verified diagnosis of COVID-19. The methods of clinical analysis (history and clinical examination) and assessment of oxygen saturation were used. For the purposes of the study, patients were distributed into groups according to age (below and over 60 years); disease severity (moderate or severe/critical clinical course), and outcome (survived or died). Results. According to analysed data, 92 patients (54.43%) were men, and 69 (40.82%) were under 60 years; 126 patients (74.5%) had a moderate and 43 (25.4%)-  severe clinical course. The disease has a gradual onset in 149 (88.1 %). The most frequent initial symptoms were fever and fatigue (60.4 %), followed by fatigue with arthro-myalgias (26.2%). Co-morbidities were documented for 140 patients (82.8%). COVID-19 was severe/critical in 14.3% of patients under 60 years and 34.1% of patients ≥ 60 years (p < 0.01), with case fatality rate 7.4% vs.  25% respectively (p < 0.001). Conclusion. Our data highlight the importance of advanced age (over 60 years) and comorbidities ( arterial hypertension, diabetes mellitus, cirrhosis hepatis) as high-risk factors for severe course and fatal outcome of COVID-19