Symptoms and risk factors for hospitalization of COVID-19 presented in primary care An exploratory retrospective study

Objective To increase knowledge of discrete symptoms shall help to avoid misinterpretation of test results and to gain better understanding of associations between early symptoms and severe disease to provide additional criteria for targeted early interventions. Design Retrospective observational study. Setting Austrian GP practices in the year 2020, patients above 18 years were included. Participants We recruited 25 practices which included 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 tabulation. 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 Only one third of patients report symptoms generally understood to be typical for COVID-19. Most patients presented with unspecific complaints. We found symptoms indicating complicated disease, depending on when they appear. The number of symptoms may be a predictor for the need of hospital care. More than 50% of patients still experience symptoms 14 days after onset. Conclusion Unspecific symptoms are valuable indicators in the detection of early COVID-19 disease that practitioners and the general public should be aware of also in the interpretation of low sensitivity tests. Monitoring patients using the indicators we identified may help to identify patients who are likely to profit from early intervention.

Automated summary

The study aimed to increase understanding of early symptoms of COVID-19, providing additional criteria for early intervention. Results showed that most patients presented with nonspecific symptoms, and the timing of symptoms may indicate complicated disease. The number of symptoms could be a predictor for hospital care.