Epidemiology, risk factors and clinical course of SARS-CoV-2 infected patients in a Swiss university hospital: An observational retrospective study

Regina, Jean; Papadimitriou-Olivgeris, Matthaios; Burger, Raphaël; Le Pogam, Marie-Annick; Niemi, Tapio; Filippidis, Paraskevas; Tschopp, Jonathan; Desgranges, Florian; Viala, Benjamin; Kampouri, Eleftheria; Rochat, Laurence; Haefliger, David; Belkoniene, Mehdi; Fidalgo, Carlos; Kritikos, Antonios; Jaton, Katia; Senn, Laurence; Bart, Pierre-Alexandre; Pagani, Jean-Luc; Manuel, Oriol; Lhopitallier, Loïc

BACKGROUND: This study aims to describe the epidemiology of COVID-19 patients in a Swiss university hospital. METHODS: This retrospective observational study included all adult patients hospitalized with a laboratory confirmed SARS-CoV-2 infection from March 1 to March 25, 2020. We extracted data from electronic health records. The primary outcome was the need to mechanical ventilation at day 14. We used multivariate logistic regression to identify risk factors for mechanical ventilation. Follow-up was of at least 14 days. RESULTS: 145 patients were included in the multivariate model, of whom 36 (24.8%) needed mechanical ventilation at 14 days. The median time from symptoms onset to mechanical ventilation was 9·5 days (IQR 7.00, 12.75). Multivariable regression showed increased odds of mechanical ventilation with age (OR 1.09 per year, 95% CI 1.03–1.16, p = 0.002), in males (OR 6.99, 95% CI 1.68–29.03, p = 0.007), in patients who presented with a qSOFA score ≥2 (OR 7.24, 95% CI 1.64–32.03, p = 0.009), with bilateral infiltrate (OR 18.92, 3.94–98.23, p<0.001) or with a CRP of 40 mg/l or greater (OR 5.44, 1.18–25.25; p = 0.030) on admission. Patients with more than seven days of symptoms on admission had decreased odds of mechanical ventilation (0.087, 95% CI 0.02–0.38, p = 0.001). CONCLUSIONS: This study gives some insight in the epidemiology and clinical course of patients admitted in a European tertiary hospital with SARS-CoV-2 infection. Age, male sex, high qSOFA score, CRP of 40 mg/l or greater and a bilateral radiological infiltrate could help clinicians identify patients at high risk for mechanical ventilation.