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Clinical implication and risk factor of pneumonia development in mild coronavirus disease 2019 patients
Hyun Woo Lee1, Seo-Young Yoon1, Jung-Kyu Lee1
1Division of Respiratory and Critical Care, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Background/Aims:
Although a majority of coronavirus disease 2019 (COVID-19) cases were characterized as mild, data assessing the development of pneumonia in mild COVID-19 patients are limited. We aimed to examine the effect of pneumonia development on the clinical course of mild COVID-19 in hospitalized patients.
Methods:
A retrospective cohort study was conducted via medical record review between February 25, 2020 and April 11, 2020 at a single center. The impact of pneumonia development on the time to viral clearance in mild COVID-19 patients was evaluated. Risk factors associated with the development of pneumonia were also identified.
Results:
Chest radiographs revealed the development of pneumonia in 26.8% of mild COVID-19 patients. The time to pneumonia development was a median of 8.0 days from the onset of symptoms and 3.5 days after hospital admission. A multivariate analysis for predicting pneumonia development identified age ≥ 65 years (odds ratio [OR], 3.15; 95% confidence interval [CI], 1.14 to 8.73), cough (OR, 2.18; 95% CI, 1.29 to 3.68), dyspnea (OR, 3.58; 95% CI, 1.10 to 11.69), and diarrhea (OR, 2.69; 95% CI, 1.51 to 4.78) as significant variables. The time to negative conversion was longer in mild COVID-19 patients who developed pneumonia (23.6 days vs. 18.4 days, p = 0.003). In Kaplan-Meier estimation and multivariate Cox regression analyses, newly developed pneumonia was significantly related with delayed time to negative conversion (log-rank test, p = 0.02; hazard ratio, 2.90; 95% CI, 1.06 to 7.97).
Conclusion:
The development of pneumonia delayed viral clearance in patients with mild COVID-19. Elderly patients or those suffering from diarrhea should be closely monitored, given the increased risk of developing pneumonia.
Insights
Pneumonia developed in 26.8% of mild COVID-19 patients, delaying viral clearance. Elderly patients and those with diarrhea face higher pneumonia risks and require close monitoring for better coronavirus disease 2019 outcomes.
Area of Science:
- Pulmonology
- Infectious Diseases
- Epidemiology
Background:
- Limited data exist on pneumonia development in mild coronavirus disease 2019 (COVID-19) cases.
- Understanding pneumonia's impact on mild COVID-19 is crucial for hospitalized patients.
Purpose of the Study:
- To investigate the effect of pneumonia development on the clinical course of mild COVID-19.
- To identify risk factors for pneumonia in mild COVID-19 patients.
Main Methods:
- Retrospective cohort study of hospitalized mild COVID-19 patients.
- Medical record review to assess pneumonia development and time to viral clearance.
- Multivariate analysis to identify risk factors for pneumonia.
Main Results:
- Pneumonia developed in 26.8% of mild COVID-19 patients, with a median onset of 8 days post-symptom onset.
- Risk factors for pneumonia included age ≥ 65, cough, dyspnea, and diarrhea.
- Pneumonia significantly delayed viral clearance (23.6 days vs. 18.4 days, p=0.003).
Conclusions:
- Pneumonia development prolongs viral clearance in mild COVID-19.
- Close monitoring of elderly patients or those with diarrhea is recommended due to increased pneumonia risk.
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