Trajectories of vital signs in patients with COVID-19

dc.creatorPimentel, Marco A.F.
dc.creatorRedfern, Oliver C.
dc.creatorHatch, Robert
dc.creatorYoung, J. Duncan
dc.creatorTarassenko, Lionel
dc.creatorWatkinson, Peter J.
dc.date.accessioned2020-11-04T15:51:08Z
dc.date.available2020-11-04T15:51:08Z
dc.date.created2020-09-01
dc.description.abstractenglishBackground The global pandemic of coronavirus disease 2019 (COVID-19) has placed a huge strain on UK hospitals. Early studies suggest that patients can deteriorate quickly after admission to hospital. The aim of this study was to model changes in vital signs for patients hospitalised with COVID-19. Methods This was a retrospective observational study of adult patients with COVID-19 admitted to one acute hospital trust in the UK (CV) and a cohort of patients admitted to the same hospital between 2013-2017 with viral pneumonia (VI). The primary outcome was the start of continuous positive airway pressure/non-invasive positive pressure ventilation, ICU admission or death in hospital. We used non-linear mixed-effects models to compare changes in vital sign observations prior to the primary outcome. Using observations and FiO2 measured at discharge in the VI cohort as the model of normality, we also combined individual vital signs into a single novelty score. Results There were 497 cases of COVID-19, of whom 373 had been discharged from hospital. 135 (36.2%) of patients experienced the primary outcome, of whom 99 died in hospital. In-hospital mortality was over 4-times higher in the CV than the VI cohort (26.5% vs 6%). For those patients who experienced the primary outcome, CV patients became increasingly hypoxaemic, with a median estimated FiO2 (0.75) higher than that of the VI cohort (estimated FiO2 of 0.35). Prior to the primary outcome, blood pressure remained within normal range, and there was only a small rise in heart rate. The novelty score showed that patients with COVID-19 deteriorated more rapidly that patients with viral pneumonia. Conclusions Patients with COVID-19 who deteriorate in hospital experience rapidly-worsening respiratory failure, with low SpO2 and high FiO2, but only minor abnormalities in other vital signs. This has potential implications for the ability of early warning scores to identify deteriorating patients.spa
dc.format.extent8 páginasspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.1016/j.resuscitation.2020.09.002spa
dc.identifier.issn0300-9572spa
dc.identifier.otherhttps://www.resuscitationjournal.com/article/S0300-9572(20)30440-8/fulltext#secsect0005spa
dc.identifier.urihttps://hdl.handle.net/20.500.12010/15312
dc.language.isospaspa
dc.publisherResuscitationspa
dc.rights.accessrightsinfo:eu-repo/semantics/restrictedAccessspa
dc.rights.localAcceso restringidospa
dc.sourcereponame:Expeditio Repositorio Institucional UJTLspa
dc.sourceinstname:Universidad de Bogotá Jorge Tadeo Lozanospa
dc.subjectvital signsspa
dc.subjectchanges in vital signs for patients hospitalised with COVID-19spa
dc.subject.lembSíndrome respiratorio agudo gravespa
dc.subject.lembCOVID-19spa
dc.subject.lembSARS-CoV-2spa
dc.subject.lembCoronavirusspa
dc.titleTrajectories of vital signs in patients with COVID-19spa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localArtículospa

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