What is the clinical course of patients hospitalised for COVID-19 treatment Ireland: a retrospective cohort study in Dublin’s North Inner City (the ‘Mater 100’)

Abstract Background: Since March 2020, Ireland has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, while several cohorts from China have been described, our understanding is limited, with no data describing the epidemiological and clinical characteristics of patients with COVID-19 in Ireland. To improve our understanding of the clinical characteristics of this emerging infection we carried out a retrospective review of patient data to examine the clinical characteristics of patients admitted for COVID-19 hospital treatment.Methods: Demographic, clinical and laboratory data on the first 100 adult patients admitted to Mater Misericordiae University Hospital (MMUH) for in-patient COVID-19 treatment after onset of the outbreak in March 2020 was extracted from clinical and administrative records. Missing data were excluded from the analysis.Results: Fifty-eight per cent were male, 63% were Irish nationals, 29% were GMS eligible, and median age was 45 years (interquartile range [IQR] =34-64 years). Patients had symptoms for a median of five days before diagnosis (IQR=2.5-7 days), most commonly cough (72%), fever (65%), dyspnoea (37%), fatigue (28%), myalgia (27%) and headache (24%). Of all cases, 54 had at least one pre-existing chronic illness (most commonly hypertension, diabetes mellitus or asthma). At initial assessment, the most common abnormal findings were: C-reactive protein >7.0mg/L (74%), ferritin >247μg/L (women) or >275μg/L (men) (62%), D-dimer >0.5μg/dL (62%), chest imaging (59%), NEWS Score (modified) of ≥3 (55%) and heart rate >90/min (51%). Twenty-seven required supplemental oxygen, of which 17 were admitted to the intensive care unit - 14 requiring ventilation. Forty received antiviral treatment (most commonly hydroxychloroquine or lopinavir/ritonavir). Four died, 17 were admitted to intensive care, and 74 were discharged home, with nine days the median hospital stay (IQR=6-11).Conclusion: Our findings reinforce the emerging consensus of COVID-19 as an acute life-threatening disease and highlights, the importance of laboratory (ferritin, C-reactive protein, D-dimer) and radiological parameters, in addition to clinical parameters. Further cohort studies involving larger samples followed longitudinally are a priority.