TY - JOUR
T1 - Impact of upper and lower respiratory symptoms on COVID-19 outcomes
T2 - a multicenter retrospective cohort study
AU - Nakagawara, Kensuke
AU - Chubachi, Shotaro
AU - Namkoong, Ho
AU - Tanaka, Hiromu
AU - Lee, Ho
AU - Azekawa, Shuhei
AU - Otake, Shiro
AU - Fukushima, Takahiro
AU - Morita, Atsuho
AU - Watase, Mayuko
AU - Sakurai, Kaori
AU - Kusumoto, Tatsuya
AU - Asakura, Takanori
AU - Masaki, Katsunori
AU - Kamata, Hirofumi
AU - Ishii, Makoto
AU - Hasegawa, Naoki
AU - Harada, Norihiro
AU - Ueda, Tetsuya
AU - Ueda, Soichiro
AU - Ishiguro, Takashi
AU - Arimura, Ken
AU - Saito, Fukuki
AU - Yoshiyama, Takashi
AU - Nakano, Yasushi
AU - Mutoh, Yoshikazu
AU - Suzuki, Yusuke
AU - Edahiro, Ryuya
AU - Murakami, Koji
AU - Sato, Yasunori
AU - Okada, Yukinori
AU - Koike, Ryuji
AU - Kitagawa, Yuko
AU - Tokunaga, Katsushi
AU - Kimura, Akinori
AU - Imoto, Seiya
AU - Miyano, Satoru
AU - Ogawa, Seishi
AU - Kanai, Takanori
AU - Fukunaga, Koichi
N1 - Funding Information:
This study was supported by AMED (JP20nk0101612, JP20fk0108415, JP21jk0210034, JP21km0405211, JP21km0405217, and JP21wm0325031), JST CREST (JPMJCR20H2), JST PRESTO (JPMJPR21R7), MHLW (20CA2054), Takeda Science Foundation, Mitsubishi Foundation, and Bioinformatics Initiative of Osaka University Graduate School of Medicine, Osaka University.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Respiratory symptoms are associated with coronavirus disease 2019 (COVID-19) outcomes. However, the impacts of upper and lower respiratory symptoms on COVID-19 outcomes in the same population have not been compared. The objective of this study was to characterize upper and lower respiratory symptoms and compare their impacts on outcomes of hospitalized COVID-19 patients. Methods: This was a multicenter, retrospective cohort study; the database from the Japan COVID-19 Task Force was used. A total of 3314 COVID-19 patients were included in the study, and the data on respiratory symptoms were collected. The participants were classified according to their respiratory symptoms (Group 1: no respiratory symptoms, Group 2: only upper respiratory symptoms, Group 3: only lower respiratory symptoms, and Group 4: both upper and lower respiratory symptoms). The impacts of upper and lower respiratory symptoms on the clinical outcomes were compared. The primary outcome was the percentage of patients with poor clinical outcomes, including the need for oxygen supplementation via high-flow oxygen therapy, mechanical ventilation, and extracorporeal membrane oxygenation or death. Results: Of the 3314 COVID-19 patients, 605, 1331, 1229, and 1149 were classified as Group 1, Group 2, Group 3, and Group 4, respectively. In univariate analysis, patients in Group 2 had the best clinical outcomes among all groups (odds ratio [OR]: 0.21, 95% confidence interval [CI]: 0.11–0.39), while patients in Group 3 had the worst outcomes (OR: 3.27, 95% CI: 2.43–4.40). Group 3 patients had the highest incidence of pneumonia, other complications due to secondary infections, and thrombosis during the clinical course. Conclusions: Upper and lower respiratory tract symptoms had vastly different impacts on the clinical outcomes of COVID-19.
AB - Background: Respiratory symptoms are associated with coronavirus disease 2019 (COVID-19) outcomes. However, the impacts of upper and lower respiratory symptoms on COVID-19 outcomes in the same population have not been compared. The objective of this study was to characterize upper and lower respiratory symptoms and compare their impacts on outcomes of hospitalized COVID-19 patients. Methods: This was a multicenter, retrospective cohort study; the database from the Japan COVID-19 Task Force was used. A total of 3314 COVID-19 patients were included in the study, and the data on respiratory symptoms were collected. The participants were classified according to their respiratory symptoms (Group 1: no respiratory symptoms, Group 2: only upper respiratory symptoms, Group 3: only lower respiratory symptoms, and Group 4: both upper and lower respiratory symptoms). The impacts of upper and lower respiratory symptoms on the clinical outcomes were compared. The primary outcome was the percentage of patients with poor clinical outcomes, including the need for oxygen supplementation via high-flow oxygen therapy, mechanical ventilation, and extracorporeal membrane oxygenation or death. Results: Of the 3314 COVID-19 patients, 605, 1331, 1229, and 1149 were classified as Group 1, Group 2, Group 3, and Group 4, respectively. In univariate analysis, patients in Group 2 had the best clinical outcomes among all groups (odds ratio [OR]: 0.21, 95% confidence interval [CI]: 0.11–0.39), while patients in Group 3 had the worst outcomes (OR: 3.27, 95% CI: 2.43–4.40). Group 3 patients had the highest incidence of pneumonia, other complications due to secondary infections, and thrombosis during the clinical course. Conclusions: Upper and lower respiratory tract symptoms had vastly different impacts on the clinical outcomes of COVID-19.
KW - COVID-19
KW - Lower respiratory tract symptoms
KW - Primary care
KW - SARS-CoV-2 infection
KW - Upper respiratory tract symptoms
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U2 - 10.1186/s12931-022-02222-3
DO - 10.1186/s12931-022-02222-3
M3 - Article
C2 - 36380316
AN - SCOPUS:85141853534
SN - 1465-9921
VL - 23
JO - Respiratory Research
JF - Respiratory Research
IS - 1
M1 - 315
ER -