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      First results of the “Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS)”

      research-article
      1 , 2 , 3 , 4 , 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 1 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 2 , 30 , 1 , 32 , 1 , 1 , 2 , 1 , 2 , 1 , 2 , 31 , 1 , 2 , 32 ,
      Infection
      Springer Berlin Heidelberg
      SARS-CoV-2, COVID-19, LEOSS, Cohort study

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          Abstract

          Purpose

          Knowledge regarding patients’ clinical condition at severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection is sparse. Data in the international, multicenter Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort study may enhance the understanding of COVID-19.

          Methods

          Sociodemographic and clinical characteristics of SARS-CoV-2-infected patients, enrolled in the LEOSS cohort study between March 16, 2020, and May 14, 2020, were analyzed. Associations between baseline characteristics and clinical stages at diagnosis (uncomplicated vs. complicated) were assessed using logistic regression models.

          Results

          We included 2155 patients, 59.7% (1,287/2,155) were male; the most common age category was 66–85 years (39.6%; 500/2,155). The primary COVID-19 diagnosis was made in 35.0% (755/2,155) during complicated clinical stages. A significant univariate association between age; sex; body mass index; smoking; diabetes; cardiovascular, pulmonary, neurological, and kidney diseases; ACE inhibitor therapy; statin intake and an increased risk for complicated clinical stages of COVID-19 at diagnosis was found. Multivariable analysis revealed that advanced age [46–65 years: adjusted odds ratio (aOR): 1.73, 95% CI 1.25–2.42, p = 0.001; 66–85 years: aOR 1.93, 95% CI 1.36–2.74, p < 0.001; > 85 years: aOR 2.38, 95% CI 1.49–3.81, p < 0.001 vs. individuals aged 26–45 years], male sex (aOR 1.23, 95% CI 1.01–1.50, p = 0.040), cardiovascular disease (aOR 1.37, 95% CI 1.09–1.72, p = 0.007), and diabetes (aOR 1.33, 95% CI 1.04–1.69, p = 0.023) were associated with complicated stages of COVID-19 at diagnosis.

          Conclusion

          The LEOSS cohort identified age, cardiovascular disease, diabetes and male sex as risk factors for complicated disease stages at SARS-CoV-2 diagnosis, thus confirming previous data. Further data regarding outcomes of the natural course of COVID-19 and the influence of treatment are required.

          Electronic supplementary material

          The online version of this article (10.1007/s15010-020-01499-0) contains supplementary material, which is available to authorized users.

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          Most cited references19

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

            Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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              Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

              There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
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                Author and article information

                Contributors
                joerg.vehreschild@uk-koeln.de
                Journal
                Infection
                Infection
                Infection
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0300-8126
                1439-0973
                1 October 2020
                1 October 2020
                : 1-11
                Affiliations
                [1 ]Department I for Internal Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
                [2 ]GRID grid.452463.2, German Center for Infection Research (DZIF), ; Brunswick, Germany
                [3 ]Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany
                [4 ]GRID grid.7839.5, ISNI 0000 0004 1936 9721, Department of Internal Medicine, Infectious Diseases, , Goethe University Frankfurt, ; Frankfurt, Germany
                [5 ]GRID grid.6936.a, ISNI 0000000123222966, Technical University Munich, Children’s Hospital, ; Munich, Germany
                [6 ]GRID grid.4567.0, ISNI 0000 0004 0483 2525, Research Unit Gene Vectors, Helmholtz Zentrum Muenchen, ; Munich, Germany
                [7 ]Clinic for Pneumology, Infectiology, Internal Medicine and Intensive Care, Hospital Dortmund gGmbH, Dortmund, Germany
                [8 ]GRID grid.5253.1, ISNI 0000 0001 0328 4908, Department of Gastroenterology and Infectiology, , Heidelberg University Hospital, ; Heidelberg, Germany
                [9 ]GRID grid.412468.d, ISNI 0000 0004 0646 2097, Department of Internal Medicine, , University Hospital Schleswig-Holstein, ; Kiel, Germany
                [10 ]GRID grid.419816.3, ISNI 0000 0004 0390 3563, Department of Gastroenterology and Infectiology, , Klinikum Ernst-von-Bergmann, ; Potsdam, Germany
                [11 ]GRID grid.411941.8, ISNI 0000 0000 9194 7179, Emergency Department, , University Hospital Regensburg, ; Regensburg, Germany
                [12 ]GRID grid.5963.9, Department of Medicine II, , University of Freiburg, ; Freiburg, Germany
                [13 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, University Clinic for Haematology, Oncology, Haemostaseology and Palliative Care, , University of Bochum, ; Minden, Germany
                [14 ]GRID grid.410712.1, Division of Infectious Diseases, Department of Internal Medicine III, , University Hospital of Ulm, ; Ulm, Germany
                [15 ]GRID grid.8379.5, ISNI 0000 0001 1958 8658, Division of Infectious Diseases, Department of Medicine II, , University of Würzburg Medical Center, ; Würzburg, Germany
                [16 ]Center of Infectiology Berlin/Prenzlauer Berg, Berlin, Germany
                [17 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Department of Neurology, , Katholisches Klinikum Bochum, Ruhr University Bochum, ; Bochum, Germany
                [18 ]GRID grid.419829.f, ISNI 0000 0004 0559 5293, 4th Department of Internal Medicine, , Klinikum Leverkusen gGmbH, ; Leverkusen, Germany
                [19 ]Department of Infectious Diseases, University Hospital Essen, University Duisburg-Essen, Essen, Germany
                [20 ]Bundeswehr Central Hospital, Koblenz, Germany
                [21 ]GRID grid.5252.0, ISNI 0000 0004 1936 973X, Department of Internal Medicine III, , Ludwig Maximilians University, ; Munich, Germany
                [22 ]German Cancer Consortium (DKTK), partner site Munich, Munich, Germany
                [23 ]Bavarian Center for Cancer Research (BZKF), Munich, Germany
                [24 ]2nd Medical Clinic, Hospital Passau, Passau, Germany
                [25 ]GRID grid.411668.c, ISNI 0000 0000 9935 6525, Department of Medicine 1, , University Hospital Erlangen, ; Erlangen, Germany
                [26 ]GRID grid.411067.5, ISNI 0000 0000 8584 9230, Medical Clinic II, , University Hospital Gießen, ; Giessen, Germany
                [27 ]Division of Infectious Diseases, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
                [28 ]GRID grid.275559.9, ISNI 0000 0000 8517 6224, Department of Internal Medicine II, , University Hospital Jena, ; Jena, Germany
                [29 ]GRID grid.10423.34, ISNI 0000 0000 9529 9877, Department of Haematology, Haemostasis, Oncology and Stem Cell Transplantation, , Hannover Medical School, ; Hannover, Germany
                [30 ]Department of Internal Medicine I, UKB University Hospital Bonn, Bonn, Germany
                [31 ]GRID grid.6936.a, ISNI 0000000123222966, Department of Internal Medicine II, School of Medicine, , Technical University of Munich, University Hospital Rechts Der Isar, ; Munich, Germany
                [32 ]GRID grid.7839.5, ISNI 0000 0004 1936 9721, Department of Internal Medicine, Hematology and Oncology, , Goethe University Frankfurt, ; Frankfurt, Germany
                Article
                1499
                10.1007/s15010-020-01499-0
                7527665
                33001409
                ef2615fc-ceae-4ff3-83c7-68b376f09da2
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 25 May 2020
                : 1 August 2020
                Categories
                Original Paper

                Infectious disease & Microbiology
                sars-cov-2,covid-19,leoss,cohort study
                Infectious disease & Microbiology
                sars-cov-2, covid-19, leoss, cohort study

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