Outpatient Management: Outcome in Patients with Moderate to Severe Acute Respiratory Syndrome Corona Virus-2 Infection

Introduction: The objective of this study was to understand the effectiveness of the early outpatient treatment of patients with CT-confirmed moderate to severe SARS-CoV-2 infection.

Methods: This is an observational, retrospective study in COVID-19 patients followed from March to May 2021 who visited the clinic as outpatients. Among these, we included adult outpatients who presented approximately within 1 week of onset of symptoms suggestive of SARS-CoV-2 infection and confirmed by high resolution computed tomography (HRCT). The oxygen saturation (SpO2) levels considered for inclusion were <94%, further categorized into a moderate and severe infection. Patients were also radiologically categorized as having a mild, moderate, or severe disease based on computed tomography severity score (CTSS).

Results: Of 200 patients, based on the SpO2 levels and availability of HRCT reports, we included data of 46 patients for analysis. These data included 29 males (63.04%) and 17 females (36.96%), with a mean age of 51.13±14.03 years. Almost 63% of these patients had ≥1 co-morbidity, most commonly, renal diseases. All the patients had been administered treatment within 6 hours of presentation and followed up for 21 days. Of the 46, 10.87% (n=5) patients had a fatal outcome all with the severe disease based on clinical criteria. The mortality rate in patients with SpO2 <90% was 13.88%, while with SpO2 >90 there were no deaths.

Conclusions: Severe hypoxia in patients with co-morbidities is important factor associated with mortality. Multiple comorbid conditions are significantly associated with mortality. CTSS does not necessarily correlate with mortality or hypoxia level. Even in severe cases with SpO2 <90% recovery is possible in most patients with early initiation of therapy.