Clinical and Virological Characteristics of Hospitalized COVID-19 Patients in a German Tertiary Care Center during the First Wave of the SARS-CoV-2 Pandemic

Background Adequate patient allocation is pivotal for optimal resource management in strained healthcare systems, and requires detailed knowledge of clinical and virological disease trajectories. Methods A cohort of 168 hospitalized adult COVID-19 patients enrolled in a prospective observational study at a large European tertiary care center was analyzed. Results Forty-four percent (71/161) of patients required invasive mechanical ventilation (IMV). Shorter duration of symptoms before admission (aOR 1.22 per day less, 95%CI 1.10-1.37, p<0.01), age 60-69 as compared to 18-59 years (aOR 4.33, 95%CI 1.07-20.10, p=0.04), and history of hypertension (aOR 5.55, 95%CI 2.00-16.82, p<0.01) were associated with need for IMV. Patients on IMV had higher maximal concentrations, slower decline rates, and longer shedding of SARS-CoV-2 than non-IMV patients (33 days, IQR 26-46.75, vs 18 days, IQR 16-46.75, respectively, p<0.01). Median duration of hospitalization was 9 days (IQR 6-15.5) for non-IMV and 49.5 days (IQR 36.8-82.5) for IMV-patients. Conclusion Our results indicate a short duration of symptoms before admission as a risk factor for severe disease and different viral load kinetics in severely affected patients. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial German and WHO international clinical Trials registry, DRKS00021688 ### Funding Statement CT is a participant in an academic program of German Research Foundation (DFG), MM is a participant in the BIH-Charite Digital Clinician Scientist Program funded by the Charite Universitaetsmedizin Berlin, the Berlin Institute of Health (BIH), and the German Research Foundation (DFG). This study was supported by the German Federal Ministry of Education and Research to LES, MW, CD, and VMC and PROVID to SH. The work of CD and VMC is supported by the Berlin Institute of Health, Charite Universitaetsmedizin Berlim and by the German Ministry of Health (Konsiliarlabor fuer Coronaviren). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: IRB of Charite-Universitaetsmedizin Berlin All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes there are no external dataset in this manuscript