The Need for Early Management in Patients With COVID-19
Audrey Giraud-Gatineau, Sébastien Cortaredona, Jean-Christophe Lagier, Matthieu Million, Philippe Brouqui, Yolande Obadia, Patrick Peretti-Watel, Didier Raoult, Stéphanie Gentile
doi:10.21203/rs.3.rs-251817/v1
In March 2020, the IHU Méditerranée Infection set up a screening and treatment center for patients with COVID-19, a system that has been ultimately recommended by French public health authorities. The recent publication of the pro les of patients hospitalized in France published by the Directorate for Research, Studies, Evaluation and Statistics gives us the opportunity to measure the impact of this multidisciplinary early management system coupled with screening on mortality at 90 days. Analysis of the data shows that the system established at IHU-MI was associated with lower mortality, taking age and sex into account. Regarding the age-standardized mortality rate, mortality rates were lower than national data regardless of the period of the epidemic. Early management seems to have signi cantly decreased the mortality rate in the under-60 age group, suggesting the importance of early management, regardless of age. In addition, these patients had pejorative clinical criteria (high NEWS-2 score, ICU visits, oxygen saturation below 95%) requiring hospitalization, and co-morbidities that are now known to be aggravating factors [7] . This reinforces the need to care for all individuals, regardless of age. Early medical care, as part of a system integrating a screening center and a day hospital, may explain the lower mortality rates.
N°: 2020-021) approved this non-interventional retrospective study. According to European General Data Protection Regulation No 2016/679, patients were informed of the potential use of their medical data and that they could refuse the use of their data. The analysis of collected data followed the reference methodology MR-004 registered on N° MR 5010010520 in the AP-HM register.
Consent for publication Not applicable.
Competing interests The authors have no competing interests.
Authors' contributions Conceived and designed the study: DR, YO and SG. Designed and/or performed experiments: AGG, SC, JCL, MM and PB. Analysed and interpreted data: AGG, YO, DR and SG. Wrote the manuscript: AGG, SC, PPW and SG. All authors read and approved the nal manuscript. Figure 1 Death rate at 90 days with 95% CI* according to age and gender (%) in France [17] and in our Institute. Figure 2 Death rate at 90 days with 95% CI* according to the month of admission in France [17] and in our Institute.
References
Bergeron, Borraz, Patrick, François DEDIEU Crise organisationnelle Sciences Les presses2020 Presses de la Fondation Nationale des sciences politiques ; Quand le sénat juge sévèrement la gestion du Covid-19, Rev Francoph Lab,
doi:10.1016/S1773-035X(20)30221-5
Brouqui, Amrane, Million, Asymptomatic hypoxia in COVID-19 is associated with poor outcome
Camoin-Jo, Gautret, Colson, High prevalence of Lupus Anticoagulant in Ambulatory COVID-19 patients: interest of Hydroxychloroquine? -IHU
Castelli, Maurin, Bartoli, Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19, Insights Imaging,
doi:10.1186/s13244-020-00939-7
Courtejoie, Dubost, Parcours hospitaliers des patients atteints de la Covid-19 lors de la première vague de l'épidémie
Dong, Du, Gardner, An interactive web-based dashboard to track COVID-19 in real time [published correction appears, Lancet Infect Dis,
doi:10.1016/S1473-3099(20)30120-1
Gudbjartsson, Helgason, Jonsson, Spread of SARS-CoV-2 in the Icelandic Population
Guedj, Million, Dudouet, F-FDG brain PET hypometabolism in post-SARS-CoV-2 infection: substrate for persistent/delayed disorders?
Je Dois M, ISOLER ? JUSQU'À QUAND M'ISOLER ?
Kwon, Ko, Shin, Sung, Kim, Drive-Through Screening Center for COVID-19: a Safe and E cient Screening System against Massive Community Outbreak, J Korean Med Sci,
doi:10.3346/jkms.2020.35.e123
Lagier, Gautret, Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis, Travel Med Infect Dis,
doi:10.1016/j.tmaid.2020.101791
Leger, Jacquier, Barral, Low-dose chest CT for diagnosing and assessing the extent of lung involvement of SARS-CoV-2 pneumonia using a semi quantitative score, PLoS One,
doi:10.1371/journal.pone.0241407
Liao, Wang, Kang, Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China, Intensive Care Med,
doi:10.1007/s00134-020-05954-2
Michot A,, Launois A, Bertranda, Bringer A, Degos A et al., enseignement, recherche -parcours de formation) et XVI (parcours de soins et organisation de soins)1 Rapport 19-02. L'hôpital public en crise : origines et propositions