Clinical Characteristics and Mortality Predictors of COVID-19 Patients Hospitalized at Nationally-Designated Treatment Hospitals

J Korean Med Sci. 2020 Sep 14;35(36):e328. doi: 10.3346/jkms.2020.35.e328.

Abstract

Background: Coronavirus disease 2019 (COVID-19) was first reported in December 2019 in China, and then it has disseminated worldwide. In Korea, a religious group-related super-spreading event triggered a sudden outbreak in Daegu city and Gyeongsangbuk-do in southeast Korea. This study was undertaken to document the clinical characteristics of patients hospitalized in Gyeongsangbuk-do.

Methods: Three hundred and fifty-two patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection hospitalized at Dongguk University Gyeongju Hospital or at the Andong Medical Center between February 18th and June 30th were enrolled in this study. Medical records were reviewed and demographic and clinical features, including comorbidities, symptoms, radiological and laboratory findings on admission were analyzed. In addition, we sought to identify risk factors of mortality.

Results: Mean age of the 352 study subjects was 56 years (range, 14-95). The mortality rate was 6.8% and mean age at death was 81 years (range, 57-91). The most common symptom was cough (31.8%) followed by a febrile sensation (28.4%), sputum (17.0%), sore throat (15.6%), and myalgia (13.1%). Eighty-one (23.0%) patients were asymptomatic, but a half of these patients exhibited pneumonic infiltration at presentation. Chest radiology showed no active lesion in 41.8% of the study subjects, bilateral pneumonia in 46.9%, and unilateral pneumonic infiltration in 11.4%. Among 24 patients that died, 18 subjects were transferred from a care facility. An age of ≥ 70 years, previous history of malignancy or diabetes, and fever (≥ 37.5°C) on admission were found to be significant risk factors of mortality.

Conclusion: Patients aged ≥ 70 years, those with fever on admission, and patients with an underlying malignancy or diabetes were found to be more likely to succumb to COVID-19. Elderly in care facilities or hospitalized patients with an underlying disease should receive more attention and be considered for preventive quarantine.

Keywords: Coronavirus; Hospitals; Korea; Mortality; Pandemics.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases
  • Betacoronavirus*
  • COVID-19
  • Comorbidity
  • Coronavirus Infections / diagnostic imaging
  • Coronavirus Infections / mortality*
  • Diabetes Mellitus / epidemiology
  • Female
  • Hospital Mortality
  • Hospitals, Special / statistics & numerical data*
  • Hospitals, University / statistics & numerical data*
  • Humans
  • Inpatients*
  • Male
  • Middle Aged
  • Neoplasms / epidemiology
  • Pandemics*
  • Pneumonia, Viral / diagnostic imaging
  • Pneumonia, Viral / mortality*
  • Quarantine
  • Republic of Korea / epidemiology
  • Risk Factors
  • SARS-CoV-2
  • Symptom Assessment