Factors associated with SARS-CoV-2 infection in patients attending an acute hospital ambulatory assessment unit

J Med Virol. 2021 Jul;93(7):4488-4495. doi: 10.1002/jmv.26966. Epub 2021 Apr 6.

Abstract

To describe the factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in mild-to-moderate patients attending for assessment. This observational study was conducted in a Model 4 tertiary referral center in Ireland. All patients referred for SARS-CoV-2 assessment over a 4-week period were included. Patient demographics, presenting symptoms, comorbidities, medications, and outcomes (including length of stay, discharge, and mortality) were collected. Two hundred and seventy-nine patients were assessed. These patients were predominantly female (62%) with a median age of 50 years (SD 16.9). Nineteen (6.8%) patients had SARS-CoV-2 detected. Dysgeusia was associated with a 16-fold increased prediction of SARS-CoV-2 positivity (p = .001; OR, 16.8; 95% CI, 3.82-73.84). Thirteen patients with SARS-COV-2 detected (68.4%) were admitted, in contrast with 38.1% (99/260) of patients with SARS-CoV-2 non-detectable or not tested (p = .001). Female patients were more likely to be hospitalized (p = .01) as were current and ex-smokers (p = .05). We describe olfactory disturbance and fever as the main presenting features in SARS-CoV-2 infection. These patients are more likely to be hospitalized with increased length of stay; however, they make up a minority of the patients assessed. "Non-detectable" patients remain likely to require prolonged hospitalization. Knowledge of predictors of hospitalization in a "non-detectable" cohort will aid future planning and discussion of patient assessment in a SARS-CoV-2 era.

Keywords: SARS coronavirus; coronavirus; epidemiology; pandemics; virus classification.

Publication types

  • Observational Study

MeSH terms

  • COVID-19 / diagnosis*
  • COVID-19 / pathology*
  • COVID-19 Nucleic Acid Testing / methods*
  • Female
  • Hospitalization
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Reverse Transcriptase Polymerase Chain Reaction / methods
  • SARS-CoV-2 / isolation & purification
  • Sex Factors
  • Tertiary Care Centers