Study of Huntington Hospital Coronavirus Patients Ties Shorter Time Between Symptom Onset and Hospitalization, to Worse Outcomes

A study of patients with the Coronavirus who were treated at Huntington Hospital after suffering varying duration of symptom onset, shows that a shorter time from symptom onset to hospitalization is associated with serious disease and death in patients with COVID-19.

“Our findings suggest that patients with COVID-19 who had significant comorbidities became acutely ill with severe presentation shortly, within 3 days, following onset of symptoms and were at significant risk for complications and death despite receipt of antiviral therapy,” the study reads. “Aggressive management and vaccine prioritization should be directed at this patient population.”

The study by USC’s School of Pharmacy was presented to the European Society of Clinical Microbiology and Infectious Diseases (ECCVID) by co-author Amanda Chron.

The authors of the study evaluated patient characteristics and the relationship between the timeline of symptoms prior to hospitalization and outcomes.

The study included 252 patients; 33 percent presented within 3 days while 27 percent were after one week from the onset of symptoms. Patients presenting within three days after symptom onset tended to be older and were more likely to have high blood pressure percent vs and chronic kidney disease than those admitted after one week.

Patients hospitalized from home due to COVID-19 between March 14 to May 14 with a positive result for the Coronavirus were evaluated to obtain demographic, laboratory, and clinical information.

Patients were grouped based on the time from onset of symptoms to hospitalization and compared for clinical characteristics, treatment, and outcomes.

However, the group that presented within three days also presented with fewer symptoms overall, such as fever, shortness of breath, non-productive cough and muscle/joint pain.

However those patients had higher levels of organ failure and a worse overall assessment based on a severity score called APACHE II, which factors in physiology, age, and chronic conditions.

This quicker-presenting group also ultimately was more likely to develop acute respiratory distress syndrome and have higher mortality than those presenting at the hospital more than one week after symptom onset.

Further analysis of the study groups revealed that just over half of the patients received antiviral therapy, and it was more likely to be given to those who presented with fever with shortness of breath and/or septic shock. Despite antiviral therapy, mortality rates remained high at 23 percent in those presenting within three days compared to 5 percent in those presenting after one week. By comparison, among those who did not receive antiviral therapy, mortality was 7 percent in the more quickly presenting group, whereas none died in the group presenting after seven days.