Among symptoms of coronavirus, difficulty breathing (dyspnoea) is significantly tied to severe illness and the likelihood of intensive care admission, according to a new study awaiting peer review.
The findings could be useful in guiding clinical management decisions early in the course of the illness, said lead author Vageesh Jain, of University College London.
In an analysis of hospital data from China, investigators found that patients who exhibited dyspnoea were about four times more likely to have severe disease and almost seven times more likely to be admitted to an intensive care unit than their peers who did not exhibit breathing troubles.
Jain and colleagues also found that chronic obstructive pulmonary disease was the most strongly predictive comorbidity for both severe disease and ICU admission. Patients with COPD were 18 times more likely to be admitted to ICU than their peers without the disease.
While not common in the patient groups studied, COPD is notably common among skilled care residents, with rates as high as 21%, according to research by Omnicare.
“When looking at ICU-admitted patients, who represent the more severe end of the spectrum of clinical severity, COPD patients are particularly vulnerable,” reported Jain.
Severe cases of COVID-19 may further progress to pulmonary distress or failure, and acute respiratory distress syndrome. Patients in this state require ventilator support, as there is currently no treatment for this syndrome, according to the ARDS Foundation.
Up to 3% of COVID-19 patients will develop ARDS, estimates Michael Matthay, a critical care medicine doctor at University of California San Francisco, as reported by The Philadelphia Inquirer.
The new investigation included seven peer-reviewed retrospective cohort studies totalling 1,813 patients, with 116 ICU patients and 315 patients classified as severe. All had confirmed COVID-19.
