COVID-19's natural course among ambulatory monitored
outpatients

J 2021

COVID-19's natural course among ambulatory monitored outpatients

WEINBERGEROVÁ, Barbora, Jiří MAYER, Štěpán HRABOVSKÝ, Zuzana NOVÁKOVÁ, Zdeněk POSPÍŠIL et. al.

Basic information

Original name

COVID-19's natural course among ambulatory monitored outpatients

Authors

WEINBERGEROVÁ, Barbora (203 Czech Republic, guarantor, belonging to the institution), Jiří MAYER (203 Czech Republic, belonging to the institution), Štěpán HRABOVSKÝ (203 Czech Republic, belonging to the institution), Zuzana NOVÁKOVÁ (203 Czech Republic, belonging to the institution), Zdeněk POSPÍŠIL (203 Czech Republic, belonging to the institution), Lucie MARTYKÁNOVÁ (203 Czech Republic, belonging to the institution), Katerina HORTOVA (203 Czech Republic), Lucie MANDELOVA (203 Czech Republic), Karel HEJDUK (203 Czech Republic, belonging to the institution), Renata CHLOUPKOVÁ (203 Czech Republic, belonging to the institution), Michal POSPÍŠIL (203 Czech Republic, belonging to the institution), Martina DOUBKOVÁ (203 Czech Republic, belonging to the institution), Vladimír MAREK (203 Czech Republic, belonging to the institution), Renata NOVOTNA (203 Czech Republic), Martin DOLEČEK (203 Czech Republic, belonging to the institution), Hana MATĚJOVSKÁ KUBEŠOVÁ (203 Czech Republic, belonging to the institution), Kristián BRAT (703 Slovakia, belonging to the institution), Radana PAŘÍZKOVÁ (203 Czech Republic, belonging to the institution), Petr HUSA (203 Czech Republic, belonging to the institution), Marek MECHL (203 Czech Republic, belonging to the institution), Zdeněk KRÁL (203 Czech Republic, belonging to the institution) and Martina LENGEROVÁ (203 Czech Republic, belonging to the institution)

Edition

Nature Scientific Reports, London, NATURE RESEARCH, 2021, 2045-2322

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

10700 1.7 Other natural sciences

Country of publisher

Germany

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.996

RIV identification code

RIV/00216224:14110/21:00121827

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1038/s41598-021-89545-1

UT WoS

000652603700004

Keywords in English

COVID-19; ambulatory monitored outpatients

Abstract

V originále

Research objective was to detail COVID-19's natural trajectory in relation to the Czech population's viral load. Our prospective detailed daily questionnaire-based telemonitoring study evaluated COVID-19's impact among 105 outpatients. In accordance with government quarantine requirements, outpatients were divided into a cohort with two negative tests at the end of the disease (40 patients) and a cohort with a new algorithm (65 patients) following a 14-day quarantine. Median follow-up differed significantly between the 2 groups (23 days vs. 16 days). Only 6% of patients were asymptomatic during the entire telemonitoring period. Another 13% of patients were diagnosed asymptomatic, as suspected contacts, yet later developed symptoms, while the remaining 81% were diagnosed as symptomatic on average 6 days following symptom onset. Telemonitoring enabled precise symptom status chronicling. The most frequently reported complaints were fevers, respiratory issues, and anosmia. Six patients were eventually hospitalized for complications detected early after routine telemonitoring. During the extended follow-up (median 181 days), anosmia persisted in 26% of patients. 79% of patients in the new quarantine algorithm cohort reported no symptoms on day 11 compared to just 56% of patients in the two negative test cohort upon first testing negative (median-19 days). The highest viral load occurred within 0-2 days of initial symptom onset. Both the PCR viral load and two consecutive PCR negative sample realizations indicated high interindividual variability with a surprisingly fluctuating pattern among 43% of patients. No definitive COVID-19 symptoms or set of symptoms excepting anosmia (59%) and/or ageusia (47%) were identified. No preexisting medical conditions specifically foreshadowed disease trajectory in a given patient. Without a PCR negativity requirement for quarantine cessation, patients could exhibit fewer symptoms. Our study therefore highlights the urgent need for routine ambulatory patient telemedicine monitoring, early complication detection, intensive mass education connecting disease demeanor with subsequent swift diagnostics, and, notably, the need to reevaluate and modify quarantine regulations for better control of SARS-CoV-2 proliferation.

Citovat

WEINBERGEROVÁ, Barbora, Jiří MAYER, Štěpán HRABOVSKÝ, Zuzana NOVÁKOVÁ, Zdeněk POSPÍŠIL, Lucie MARTYKÁNOVÁ, Katerina HORTOVA, Lucie MANDELOVA, Karel HEJDUK, Renata CHLOUPKOVÁ, Michal POSPÍŠIL, Martina DOUBKOVÁ, Vladimír MAREK, Renata NOVOTNA, Martin DOLEČEK, Hana MATĚJOVSKÁ KUBEŠOVÁ, Kristián BRAT, Radana PAŘÍZKOVÁ, Petr HUSA, Marek MECHL, Zdeněk KRÁL and Martina LENGEROVÁ. COVID-19's natural course among ambulatory monitored outpatients. Nature Scientific Reports. London: NATURE RESEARCH, 2021, vol. 11, No 1, p. 1-16. ISSN 2045-2322. Available from: https://dx.doi.org/10.1038/s41598-021-89545-1.

@article{1778180,
   author = {Weinbergerová, Barbora and Mayer, Jiří and Hrabovský, Štěpán and Nováková, Zuzana and Pospíšil, Zdeněk and Martykánová, Lucie and Hortova, Katerina and Mandelova, Lucie and Hejduk, Karel and Chloupková, Renata and Pospíšil, Michal and Doubková, Martina and Marek, Vladimír and Novotna, Renata and Doleček, Martin and Matějovská Kubešová, Hana and Brat, Kristián and Pařízková, Radana and Husa, Petr and Mechl, Marek and Král, Zdeněk and Lengerová, Martina},
   article_location = {London},
   article_number = {1},
   doi = {http://dx.doi.org/10.1038/s41598-021-89545-1},
   keywords = {COVID-19; ambulatory monitored outpatients},
   language = {eng},
   issn = {2045-2322},
   journal = {Nature Scientific Reports},
   title = {COVID-19's natural course among ambulatory monitored outpatients},
   url = {https://www.nature.com/articles/s41598-021-89545-1.pdf},
   volume = {11},
   year = {2021}
}

TY  - JOUR
ID  - 1778180
AU  - Weinbergerová, Barbora - Mayer, Jiří - Hrabovský, Štěpán - Nováková, Zuzana - Pospíšil, Zdeněk - Martykánová, Lucie - Hortova, Katerina - Mandelova, Lucie - Hejduk, Karel - Chloupková, Renata - Pospíšil, Michal - Doubková, Martina - Marek, Vladimír - Novotna, Renata - Doleček, Martin - Matějovská Kubešová, Hana - Brat, Kristián - Pařízková, Radana - Husa, Petr - Mechl, Marek - Král, Zdeněk - Lengerová, Martina
PY  - 2021
TI  - COVID-19's natural course among ambulatory monitored outpatients
JF  - Nature Scientific Reports
VL  - 11
IS  - 1
SP  - 1-16
EP  - 1-16
PB  - NATURE RESEARCH
SN  - 20452322
KW  - COVID-19
KW  - ambulatory monitored outpatients
UR  - https://www.nature.com/articles/s41598-021-89545-1.pdf
N2  - Research objective was to detail COVID-19's natural trajectory in relation to the Czech population's viral load. Our prospective detailed daily questionnaire-based telemonitoring study evaluated COVID-19's impact among 105 outpatients. In accordance with government quarantine requirements, outpatients were divided into a cohort with two negative tests at the end of the disease (40 patients) and a cohort with a new algorithm (65 patients) following a 14-day quarantine. Median follow-up differed significantly between the 2 groups (23 days vs. 16 days). Only 6% of patients were asymptomatic during the entire telemonitoring period. Another 13% of patients were diagnosed asymptomatic, as suspected contacts, yet later developed symptoms, while the remaining 81% were diagnosed as symptomatic on average 6 days following symptom onset. Telemonitoring enabled precise symptom status chronicling. The most frequently reported complaints were fevers, respiratory issues, and anosmia. Six patients were eventually hospitalized for complications detected early after routine telemonitoring. During the extended follow-up (median 181 days), anosmia persisted in 26% of patients. 79% of patients in the new quarantine algorithm cohort reported no symptoms on day 11 compared to just 56% of patients in the two negative test cohort upon first testing negative (median-19 days). The highest viral load occurred within 0-2 days of initial symptom onset. Both the PCR viral load and two consecutive PCR negative sample realizations indicated high interindividual variability with a surprisingly fluctuating pattern among 43% of patients. No definitive COVID-19 symptoms or set of symptoms excepting anosmia (59%) and/or ageusia (47%) were identified. No preexisting medical conditions specifically foreshadowed disease trajectory in a given patient. Without a PCR negativity requirement for quarantine cessation, patients could exhibit fewer symptoms. Our study therefore highlights the urgent need for routine ambulatory patient telemedicine monitoring, early complication detection, intensive mass education connecting disease demeanor with subsequent swift diagnostics, and, notably, the need to reevaluate and modify quarantine regulations for better control of SARS-CoV-2 proliferation.
ER  -

WEINBERGEROVÁ, Barbora, Jiří MAYER, Štěpán HRABOVSKÝ, Zuzana NOVÁKOVÁ, Zdeněk POSPÍŠIL, Lucie MARTYKÁNOVÁ, Katerina HORTOVA, Lucie MANDELOVA, Karel HEJDUK, Renata CHLOUPKOVÁ, Michal POSPÍŠIL, Martina DOUBKOVÁ, Vladimír MAREK, Renata NOVOTNA, Martin DOLEČEK, Hana MATĚJOVSKÁ KUBEŠOVÁ, Kristián BRAT, Radana PAŘÍZKOVÁ, Petr HUSA, Marek MECHL, Zdeněk KRÁL and Martina LENGEROVÁ. COVID-19's natural course among ambulatory monitored outpatients. \textit{Nature Scientific Reports}. London: NATURE RESEARCH, 2021, vol.~11, No~1, p.~1-16. ISSN~2045-2322. Available from: https://dx.doi.org/10.1038/s41598-021-89545-1.

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