Alterations with PCR Positivity at Admission and Predictive Factors of Prolonged Hospital Stay in COVID-19

S. Altın
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Abstract

Introduction: The aim of the present study is to investigate the baseline predictive factors of prolonged hospital stay and to compare the patient characteristics according to polymerase chain reaction (PCR) positivity. Methods: Between March 11 and June 1, 2020, 234 patients hospitalized in a non-intensive care unit clinic with a diagnosis of COVID-19 were included retrospectively. The duration of hospitalization were classified as ≤7 days and >7 days. Furthermore, according to real-time PCR (RT-PCR) of nasopharyngeal swab positivity, patients were divided into two Groups. Results: Of all the 234 patients, the mean age was 54±13 and 167 (71%) was male. Thirty-six (36%) were PCR positive (+) at the first swab samples. Hospital stay was longer than 7 days in 122 (52%) of the patients. Ten patients (4.3%) died within 60-days. PCR-positive cases had lower baseline leukocytes (p=0.002), C-reactive protein (p=0.001) values, whereas hemoglobin (p=0.001) and albumin levels (p<0.0001) were detected in PCR-positive patients. While demographics and mortality were similar, hospital stay longer than 7 days were detected in a higher rate in PCR-positive patients (p=0.025). The analysis on hospital stay proved that, apart from PCR positivity rate, baseline aspartate aminotransferase (AST) level prolongs hospital stay in COVID-19 patients. Discussion and Conclusion: This study demonstrates significant differences in patients with and without PCR positivity. Higher baseline AST levels and first PCR positivity prolongs hospital stay. Studies including larger patient groups would be better determine and enhance in this regard.
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新冠肺炎患者入院时PCR阳性变化及延长住院时间的预测因素
前言:本研究旨在探讨延长住院时间的基线预测因素,并根据聚合酶链反应(PCR)阳性比较患者特征。方法:回顾性分析2020年3月11日至6月1日期间在非重症监护病房门诊诊断为COVID-19的234例患者。住院时间分为≤7天和>7天。根据鼻咽拭子实时荧光定量PCR (RT-PCR)阳性情况将患者分为两组。结果:234例患者平均年龄(54±13岁),男性167例(71%)。36例(36%)首次拭子标本PCR阳性(+)。住院时间超过7天的患者122例(52%)。10例(4.3%)患者在60天内死亡。pcr阳性患者的基线白细胞(p=0.002)、c反应蛋白(p=0.001)值较低,而pcr阳性患者的血红蛋白(p=0.001)和白蛋白水平(p<0.0001)较低。虽然人口统计学和死亡率相似,但pcr阳性患者住院时间超过7天的比例更高(p=0.025)。住院时间分析证实,除了PCR阳性率外,基线天冬氨酸转氨酶(AST)水平延长了COVID-19患者的住院时间。讨论与结论:本研究显示PCR阳性与非PCR阳性患者存在显著差异。较高的AST基线水平和首次PCR阳性延长了住院时间。包括更大患者群体的研究将更好地确定和加强这方面的研究。
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