Symptoms and risk factors for hospitalization of COVID-19 presented in primary care

Objective

To extend knowledge of early symptoms as a precondition of early identification, and to gain understanding of associations between early symptoms and the development of a severe course of the disease.

Design

Retrospective observational study

Setting

Austrian GP practices in the year 2020, patients above 18 years were included.

Participants

We recruited 22 practices who included altogether 295 participants with a positive SARS-CoV-2 test.

Main outcome measures

Data collection comprised basic demographic data, risk factors and the recording of symptoms at several points in time in the course of the illness. Descriptive analyses for possible associations between demographics and symptoms were conducted by means of cross table. Group differences (hospitalized yes/no) were assessed using Fisher’s exact test. The significance level was set to 0.05; due to the observational character of the study, no adjustment for multiplicity was performed.

Results

Little more than one third of patients report symptoms generally understood to be typical for Covid-19. Most patients present with a variety of unspecific complaints. We found symptoms indicating complicated disease, depending on when they appear. The number of symptoms is likely to be a predictor for the need of hospital care. More than 50% of patients still experience symptoms 14 days after onset.

Conclusions

Underrating unspecific symptoms as possible indicators for SARS-CoV-2 infection harbours the danger of overlooking early disease. Monitoring patients during their illness using the indicators for severe disease we identified may help to identify patients who are likely to profit from early intervention.

Data availability statement

All data referred to in the manuscript are available from: Department of General Medicine and Family Practice, Karl Landsteiner Privatuniversitaet, Krems, Austria

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