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Factors Associated with Prompt Recovery among Hospitalized Patients with Coronavirus Disease 2019
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  • Pamela Ny,
  • Corey Kelsom,
  • Amanda Chron,
  • Mimi Lou,
  • Paul Nieberg,
  • Kimberly Shriner,
  • Holly Huse,
  • Annie Wong-Beringer
Pamela Ny
Huntington Memorial Hospital

Corresponding Author:pamela.ny@huntingtonhospital.com

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Corey Kelsom
Huntington Memorial Hospital
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Amanda Chron
University of Southern California
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Mimi Lou
University of Southern California
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Paul Nieberg
Huntington Memorial Hospital
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Kimberly Shriner
Huntington Memorial Hospital
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Holly Huse
Huntington Memorial Hospital
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Annie Wong-Beringer
Huntington Memorial Hospital
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Abstract

Background: Patients who survived hospitalization for COVID-19 experienced varying durations of illness but the factors associated with prompt recovery are unknown. This study identifies factors differentiating hospitalized patients who recovered promptly vs. survived a prolonged course of illness due to COVID-19. Methods: This was a retrospective study from March-August 2020 of hospitalized adults with COVID-19 which were grouped based on time to recovery: short (≤ 3 days), intermediate (4-10 days), and prolonged (>10 days). Recovery was defined as resolution of fever, tachypnea, hypotension, extubation and return of mental status at baseline. Multivariate analysis was used to evaluate factors associated with prompt recovery. Results: Among 508 patients hospitalized for COVID-19, 401 (79%) survived. Of those, prompt recovery (within 3 days) was achieved in 43% (174/401) whereas 23% (92/401) recovered after a prolonged period of > 10 days. Overall, median age was 64 y with 73% admitted from home and 25% from a skilled nursing facility. Predictors for prompt recovery upon admission included female sex (OR, 1.8; 95% CI, 1.1-2.7; p = 0.01), no fever (OR, 1.6; 95% CI, 1.1-2.6; p = 0.03), longer time from symptom onset to hospitalization (OR, 1.1; 95% CI, 1.0-1.1; p = 0.001), no supplemental oxygen (OR, 1.9; 95% CI, 1.2-3.0; p = 0.004), no direct ICU admission (OR, 41.7; 95% CI, 2.4-740.4; p = 0.01) and absence of bacterial co-infections (OR, 2.5; 95% CI, 1.5-4.0, p = 0.0003). Conclusions: Our study provides relevant data that could help clinicians triage competing resources in health systems that are challenged by the ebb and flow of COVID-19 cases by identifying clinical features of COVID-19 patients who may require less intensive management including avoidance of unnecessary antibacterial therapy.
24 Feb 2021Submitted to International Journal of Clinical Practice
25 Feb 2021Submission Checks Completed
25 Feb 2021Assigned to Editor
28 Feb 2021Reviewer(s) Assigned
09 Jul 2021Review(s) Completed, Editorial Evaluation Pending
12 Jul 2021Editorial Decision: Revise Major
20 Jul 20211st Revision Received
21 Jul 2021Submission Checks Completed
21 Jul 2021Assigned to Editor
21 Jul 2021Review(s) Completed, Editorial Evaluation Pending
25 Jul 2021Reviewer(s) Assigned
03 Sep 2021Editorial Decision: Accept