Outcome of noncritical COVID-19 patients with early hospitalization and early antiviral treatment outside the ICU
Nursel Çalik Başaran, Oğuz Abdullah Uyaroğlu, Gülçin Telli Dizman, Lale Özişik, Taha Koray Şahin, Zahit Taş, Ahmet Çağkan İnkaya, Sevilay Karahan, Şehnaz Alp, Alpaslan Alp, Gökhan Metan, Pınar Zarakolu, Gülay Sain Güven, Şerife Gül Öz, Arzu Topeli, Ömrüm Uzun, Murat Akova, Serhat Ünal
TURKISH JOURNAL OF MEDICAL SCIENCES, doi:10.3906/sag-2006-173
World Health Organization (2020) . Coronavirus Disease (COVID-19) Situation Report [online]. Website: https://www.who.int/docs/default-source/ coronaviruse/situation-reports/ 20200513-covid-19-sitrep-114.pdf?sfvrsn=17ebbbe_4 [accessed 06 06 2020]. Turkey ranks at 12 in the list of countries with the highest number of cases, with a total number of infected patients reaching 170,000, with more than 4000 deaths in the 3 months after the first COVID-19 case was reported Background/aim: Despite the fact that the COVID-19 pandemic has been going on for over 5 months, there is yet to be a standard management policy for all patients including those with mild-to-moderate cases. We evaluated the role of early hospitalization in combination with early antiviral therapy with COVID-19 patients in a tertiary care university hospital.
Materials and methods: This was a prospective, observational, single-center study on probable/confirmed COVID-19 patients hospitalized in a tertiary care hospital on COVID-19 wards between March 20 and April 30, 2020. The demographic, laboratory, and clinical data were collected.
Results: We included 174 consecutive probable/confirmed COVID-19 adult patients hospitalized in the Internal Medicine wards of the University Adult Hospital between March 20 and April 30, 2020. The median age was 45.5 (19-92) years and 91 patients (52.3%) were male. One hundred and twenty (69%) were confirmed microbiologically, 41 (23.5%) were radiologically diagnosed, and 13 (7.5%) were clinically suspected (negative microbiological and radiological findings compatible with COVID-19); 35 (20.1%) had mild, 107 (61.5%) moderate disease, and 32 (18.4%) had severe pneumonia. Out of 171 cases, 130 (74.3%) showed pneumonia; 80 were typical, and 50 showed indeterminate infiltration for COVID-19. Patients were admitted within a median of 3 days (0-14 days) after symptoms appear. The median duration of hospitalization was 4 days (0-28 days). In this case series, 13.2% patients were treated with hydroxychloroquine alone, 64.9% with hydroxychloroquine plus azithromycin, and 18.4% with regimens including favipiravir. A total of 15 patients (8.5%) were transferred to the ICU. Four patients died (2.2%).
Conclusion: In our series, 174 patients were admitted to the hospital wards for COVID-19, 69% were confirmed with PCR and/or antibody test. At the time of admission, nearly one fifth of the patients had severe diseases. Of the patients, 95.4% received hydroxychloroquine alone or in combination. The overall case fatality rate was 2.2%.
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