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Non-hospitalized Adults with COVID-19 Differ Noticeably from Hospitalized Adults in Their Demographic, Clinical, and
Sharon H Bergquist1, Clyde Partin1, David L Roberts1
1Department of Medicine, Emory University, 1365 Clifton Rd, A1400, Atlanta, GA 30322 USA.
Insights
Characteristics of non-hospitalized coronavirus disease 2019 (COVID-19) patients reveal differences from hospitalized cases. This study highlights the need for broader awareness and testing for COVID-19 in ambulatory settings.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- COVID-19 (coronavirus disease 2019) characteristics are mainly known from hospitalized adults.
- Understanding non-hospitalized COVID-19 cases is crucial for tracking its evolving epidemiology.
- Ambulatory care data provides insights into the broader spectrum of SARS-CoV-2 (the virus that causes COVID-19) infection.
Purpose of the Study:
- To describe the demographics, comorbidities, clinical presentation, and social factors of non-hospitalized adults with confirmed SARS-CoV-2 infection.
- To compare the characteristics of ambulatory COVID-19 patients with those previously reported in hospitalized populations.
- To inform public health strategies and clinical awareness regarding COVID-19 in outpatient settings.
Main Methods:
- Retrospective medical record review of 208 SARS-CoV-2 positive patients.
- Patients were managed in a COVID-19 virtual outpatient clinic within an academic health system.
- Data collected included demographics, comorbidities, symptoms, social factors, and care needs.
Main Results:
- The average age of non-hospitalized patients was 47.8 years, with 69.2% being female.
- Nearly 70% had at least one comorbidity; common symptoms included cough (75.5%), loss of smell/taste (63%), and headache (62%).
- Most patients experienced mild to moderate symptoms, had available caregivers, and initiated self-isolation, with care needs generally met.
Conclusions:
- Demographic and clinical features of non-hospitalized COVID-19 patients differ significantly from hospitalized individuals.
- Younger and seemingly healthier individuals may be at risk and warrant consideration for testing and self-isolation recommendations.
- Social factors play a role in the effectiveness of preventive measures and resource allocation during the SARS-CoV-2 pandemic.
Abstract:
The characteristics of patients with coronavirus disease 2019 (COVID-19) have primarily been described in hospitalized adults. Characterization of COVID-19 in ambulatory care is needed for a better understanding of its evolving epidemiology. Our aim is to provide a description of the demographics, comorbidities, clinical presentation, and social factors in confirmed SARS-CoV-2-positive non-hospitalized adults. We conducted a retrospective medical record review of 208 confirmed SARS-CoV-2-positive patients treated in a COVID-19 virtual outpatient management clinic established in an academic health system in Georgia. The mean age was 47.8 (range 21-88) and 69.2% were female. By race/ethnicity, 49.5% were non-Hispanic African American, 25.5% other/unknown, 22.6% non-Hispanic white, and 2.4% Hispanic. Nearly 70% had at least one preexisting medical condition. The most common presenting symptoms were cough (75.5%), loss of smell or taste (63%), headache (62%), and body aches (54.3%). Physician or advanced practice provider assessed symptom severity ranged from 51.9% mild, 30.3% moderate, and 1.4% severe. Only eight reported limitations to home care (3.8%), 55.3% had a caregiver available, and 93.3% reported initiating self-isolation. Care needs were met for 83.2%. Our results suggest the demographic and clinical characteristics of COVID-19 illness in non-hospitalized adults differ considerably from hospitalized patients and warrant greater awareness of risk among younger and healthier individuals and consideration of testing and recommending self-isolation for a wider spectrum of clinical symptoms by clinicians. Social factors may also influence the efficacy of preventive strategies and allocation of resources toward the SARS-CoV-2 pandemic.
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