Summary

Respiratory rate as a predictor of severity in outpatients with SARS-CoV-2 infection

Cristina García Marichal¹, Manuel Francisco Aguilar Jerez², Onán Pérez Hernández³, Fernando Armas González³, Luciano Delgado Plasencia^4,5, Candelaria Martín González^3,5

Affiliation of the authors

¹Gerencia de Servicios Sanitarios de La Gomera, Servicio Canario de la Salud, Spain. ²Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain. ³Servicio de Medicina Interna, Hospital Universitario de Canarias. Spain. ⁴Sección de Cirugía de Urgencias, Servicio de Cirugía General y Digestiva. Hospital Universitario de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain. ⁵Facultad de Ciencias de la Salud, Sección de Medicina. Universidad de La Laguna, Tenerife. Spain.

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García Marichal C, Aguilar Jerez MF, Pérez Hernández O, Armas González F, Delgado Plasencia L, Martín González C. Respiratory rate as a predictor of severity in outpatients with SARS-CoV-2 infection. Rev Esp Urg Emerg. 2024;3:144–9

Summary

OBJECTIVE. To evaluate the usefulness of respiratory rate (RR) as a predictor of severity in community-treated SARS-CoV-2 infection and to analyze the association of RR with course of disease.
MATERIAL AND METHODS. We included case records for 4019 patients with SARS-CoV-2 infection diagnosed in the community who were over the age of 60 years and/or were considered at high risk. The following clinical data were recorded for all patients: baseline oxygen saturation, blood pressure, temperature, heart rate, RR, and symptoms. Routine laboratory analyses and chest x-rays were also ordered for patients who were admitted to hospital.
RESULTS. Three hundred thirty-six patients (8.4%) were transferred to an emergency department, 293 (7.3%) were admitted, and 3726 were followed during treatment in the community. RR was associated with the number of days hospitalized (ρ, 0.15; P = .014). Tachypnea was associated with higher comorbidity, more symptoms (P < .001 for all symptoms evaluated), admission to an intensive
care unit (46.6% vs 28.0%; χ2 = 6.49; P = .011) with elevated markers of inflammation. None of the community-treated patients died (vs 28 of the hospitalized patients). Tachypnea observed during community treatment was associated with higher mortality (in 43% vs 2.9%; χ2 = 133.29; P < .001). RR was a predictor of admission to hospital (area under the receiver operating characteristic curve,
0.789 ± 0.015; 95% CI, 0.759-0.818; P < .001).
CONCLUSIONS. RR is a useful as a clinical sign that predicts hospital admission and mortality.