Characteristics and Outcomes of Hospitalized Young Adults with Mild Covid-19

  1. Arvind Kumar Sharma
  2. Asrar Ahmed
  3. Vaseem Naheed Baig
  4. Prahalad Dhakad
  5. Gaurav Dalela
  6. Sudhanshu Kacker
  7. Vasim Raja Panwar
  8. Raja Babu Panwar
  9. Rajeev Gupta

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

Background

Stormy course has been reported among hospitalized adults with covid-19 in high- and middle-income countries. To assess clinical outcomes in consecutively hospitalized patients with mild covid-19 in India we performed a study.

Methods

We developed a case registry of successive patients admitted with suspected covid-19 infection to our hospital (n=501). Covid-19 was diagnosed using reverse transcriptase polymerase chain reaction (RT-PCR). Demographic, clinical, investigations details and outcomes were recorded. Descriptive statistics are presented.

Results

Covid-19 was diagnosed in 234 (46.7%) and data compared with 267 (53.3%) negative controls. Mean age of covid-9 patients was 35.1±16.6y, 59.4% were <40y and 64% men. Symptoms were in less than 10% and comorbidities were in 4-8%. History of BCG vaccination was in 49% cases vs 10% controls. Cases compared to controls had significantly greater white cell (6.96+1.89 vs 6.12+1.69×10 9 cells/L) and lower lymphocyte count (1.98+0.79 vs 2.32+0.91×10 9 cells/L). No radiological and electrocardiographic abnormality was observed. All these were isolated or quarantined in the hospital and observed. Covid-19 patients received hydroxychloroquine and azithromycin according to prevalent guidelines. One patient needed oxygen support while hospital course was uncomplicated in the rest. All were discharged alive. Conversion to virus negative status was in 10.2±6.4 days and was significantly lower in age >40y (9.1±5.2) compared to 40-59y (11.3±6.1) and ≥60y (16.4±13.3) (p=0.001).

Conclusions

This hospital-based registry shows that mildly symptomatic or asymptomatic young covid-19 patients have excellent prognosis.

    What is already known on this subject?

  • High rates of morbidity and mortality following hospitalization for covid-19 has been reported from most developed countries.

  • In most developing countries covid-19 patients with mild disease are also hospitalized due to lack of home isolation. Clinical outcome of such patients has not been well studied.

    What this study adds?

  • We performed a clinical registry of successive young patients with mild covid-19 hospitalized with minimal symptoms and comorbidities.

  • None of the patients developed complications and all were discharged alive.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.06.02.20106310: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIACUC: The study has been approved by the college administration and institutional ethics committee (Registration No. ECR/762/lnst/RJ/2015) was notified accordingly.
    IRB: Ethics committee clearance has been obtained for publication of this report.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses: The data were computerized and data processing was performed using commercially available software (SPSS v.20.0).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    A major limitation of our study is recruitment of younger patients who are either asymptomatic carriers or those with minimal disease. There is need to study older patients with multiple comorbidities. A small sample size is also a limitation although we included all successive patients admitted to our hospital. This is, also, one of the larger covid-19 registries from India on patients with mild disease. We also did not perform investigations in the whole cohort as many patients refused consent. Chest computed tomographic scan is superior to diagnose early evidence of pulmonary involvement, but due to lack of symptoms and signs of major respiratory involvement and absence of prolonged hypoxia in any of the patients, this was deferred. Furthermore, the duration of RT-PCR positivity from the time of diagnosis in asymptomatic patients may be underestimated due to lack of major symptoms, making it challenging to determine when these cases were infected and become non-contagious. In conclusion, despite its small sample size, this study is the first and largest report of patients with covid-19 from this region of the country. We have shown that younger patients with low comorbidities have extremely low rate of complications of the disease. This is an important message for the public and policy makers to highlight the essentially benign nature of this disease in the young.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.06.02.20106310v1 on medRxiv