Severity of coronavirus respiratory tract infections in adults admitted to acute care in Toronto, Ontario

J Clin Virol. 2020 May:126:104338. doi: 10.1016/j.jcv.2020.104338. Epub 2020 Mar 29.

Abstract

Background: The World Health Organization has highlighted the need for improved surveillance and understanding of the health burden imposed by non-influenza RNA respiratory viruses. Human coronaviruses (CoVs) are a major cause of respiratory and gastrointestinal tract infections with associated morbidity and mortality.

Objectives: The objective of our study was to characterize the epidemiology of CoVs in our tertiary care centre, and identify clinical correlates of disease severity.

Study design: A cross-sectional study was performed of 226 patients admitted with confirmed CoV respiratory tract infection between 2010 and 2016. Variables consistent with a severe disease burden were evaluated including symptoms, length of stay, intensive care unit (ICU) admission and mortality.

Results: CoVs represented 11.3% of all positive respiratory virus samples and OC43 was the most commonly identified CoV. The majority of infections were community-associated while 21.6% were considered nosocomial. The average length of stay was 11.8 days with 17.3% of patients requiring ICU admission and an all-cause mortality of 7%. In a multivariate model, female gender and smoking were associated with increased likelihood of admission to ICU or death.

Conclusion: This study highlights the significant burden of CoVs and justifies the need for surveillance in the acute care setting.

Keywords: Coronavirus; Disease burden; Prevalence; Respiratory tract infection; Risk factors.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cigarette Smoking / adverse effects*
  • Cohort Studies
  • Coronavirus / physiology*
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / mortality
  • Coronavirus Infections / virology
  • Cross-Sectional Studies
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Ontario / epidemiology
  • Prevalence
  • Prognosis
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / mortality
  • Respiratory Tract Infections / virology
  • Sex Factors
  • Young Adult