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\begin{document}

\title{Clinical characteristics and progression of COVID-19 confirmed cases
admitted to a single British clinical centre-a brief case series report}



\author[1]{joanne conway}%
\author[1]{anna gould}%
\author[1]{richard westley}%
\author[1]{suneil raju}%
\author[1]{anja oklopcic}%
\author[1]{alex broadbent}%
\author[1]{Ahmed Hafiz}%
\affil[1]{Affiliation not available}%


\vspace{-1em}



  
  \date{March 12, 2025}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Objectives: In December 2019, a pneumonia like illness was first
reported in Wuhan-China caused by a new coronavirus named corona virus
disease -2019 (COVID-19) which then spread to cause a global pandemic.
Most of the available data in the literature is derived from Chinese
cohorts and we aim to contribute the clinical experience of a single
British clinical centre with the characteristics of a British cohort.
Design: A prospective case series. Setting: A single clinical centre in
the UK. Methods: We have collected the demographics and medical
characteristics of all COVID-19 positive cases admitted over two-week
period. All cases were diagnosed by PCR. Results: Total of 71 COVID-19
patients were included in this case series. Majority of patients (75\%)
were [?]75 years old and 58\% were men. Pre-existing comorbidities was
common (85\% of patients). Most patients presented with respiratory
symptoms such as fever (59\%), shortness of breath (56\%) and cough
(55\%). Gastrointestinal symptoms were second most common presenting
compliant such as diarrhoea (10\%) and abdominal pain (7\%).
Opacification in chest X-rays were demonstrated in 45\% of patients. All
patients received supportive treatment and no specific antiviral therapy
was administered in this cohort. So far, 18 (25\%) patients have fully
recovered, 9 patients (13\%) escalated to a higher level of care and 10
(14\%) have died. Patients who died were non-significantly older than
those who have recovered (78.0 v 69.2 years, p=0.15) but they had a
significantly higher clinical frailty scores (5.75 v 3.36, p=0.005).
Conclusion: This case series demonstrated that the characteristics of
British COVID-19 patients were generally similar to what is published in
literature although we report more gastrointestinal symptoms at
presentation. We have identified frailty as a risk factor for adverse
outcome in COVID-19 patients and suggest that it should be included in
the future vaccination recommendations.%
\end{abstract}%



\sloppy


\textbf{Introduction}

The respiratory disease COVID-19 was initially reported in Wuhan-Hubei
province-China. \textsuperscript{1} The disease has since become a
global pandemic. COVID-19 spreads rapidly by human-to-human
transmission, primarily through respiratory droplets, physical contact
and via fomites. \textsuperscript{2} Compared with influenza, COVID-19
is thought to have a higher reproductive number of 2-2.5 (more people
will be infected per index case) but a longer serial interval of 5-6
days (compared with 3 days for influenza). \textsuperscript{3} COVID-19
typically presents with fever, myalgia, fatigue and dyspnoea or with
less common gastrointestinal symptoms and headache.
\textsuperscript{2}Chest imaging shows bilateral patchy shadows, and
blood tests often reveal lymphopaenia. \textsuperscript{4} A fatality
rate of 2.3\% across all age groups, 14.8\% in patients [?]80 years old
and 8.0\% in those 70-79 of age has been reported. \textsuperscript{5}
Mortality was found to be higher in patients with pre-existing
comorbidities.\textsuperscript{5} Most of the available data in the
literature is derived from Chinese cohorts of patients. The objective of
this case series is to collect clinical data on patients'
characteristics, clinical presentations, laboratory findings, and
progression of patients admitted to a District General Hospital in the
UK with confirmed COVID-19 tests. Our aim is to contribute the clinical
experience of a single British clinical centre to the rapidly growing
global data pool on this new life-threatening respiratory disease.

\textbf{Methods}

Design

A prospective case series.

Setting

District general hospital in UK. Patients are first admitted into acute
medical unit (AMU) which accepts non-selective cases with acute medical
conditions. The unit is open to other specialties input, if required,
including access to intensive care unit (ICU) for severely ill patients.
As a routine practice, a Do Not Attempt Resuscitation (DNAR) form is
usually singed by a senior medical officer after discussion with the
patients and their families.

Case definition

We have included all the COVID-19 confirmed cases admitted over 2-week
period from 23\textsuperscript{rd} March to 4\textsuperscript{th} April
2020. Initial screening for cases was undertaken in line with Public
Health England (PHE) which identifies suspected case as those presenting
with clinical or radiological evidence of pneumonia, fever and
respiratory symptoms. \textsuperscript{6}

Case confirmation

Patients meeting the above criteria then had nasopharyngeal and
oropharyngeal swabs for identification of 2019-nCoV nucleic acid by
reverse transcription polymerase chain reaction (RT-PCR). Patients who
tested negative by RT-PCR but still have a high index of clinical
suspicion were re-tested with a further swab for RT-PCR. All suspected
patients had an initial chest X-ray, some had a CT scan based on
clinical requirement. CT scan was not used as a diagnostic tool and all
of the patients had a RT-PCR confirmed diagnosis.

Data collection

We identified all COVID-19 cases from our laboratory data-base which has
been followed up on a daily basis. Medical records were reviewed and
patients' demographic, medical and social history was collected.
Laboratory and radiological information were available in the electronic
records. We used a standardised data collection sheet which was used by
all the authors. To assess frailty, we used the clinical frailty score
(CFS) which classify patients in a range of very fit (score 1) to
terminally ill (score 9). \textsuperscript{7}

\textbf{Statistical analysis}

Continuous variables are presented as means and standard deviations (SD)
and categorical ones as percentages. The t-test t test was used for
continuous variables and two-sided p value of \textless{}0.05 was
considered significant. We displayed descriptive statistics using the
statistical software package StataCorp. 2019. Stata Statistical
Software: Release 16. College Station, TX: StataCorp LLC.

\textbf{Results}

Total of 71 COVID-19 confirmed consecutive cases who were admitted to
hospital over 2 week period were included. Patient demographics are
displayed in Table 1. Majority (75\%) of patients were [?]65 years old,
58\% were men and the source of infection was unidentified in the
majority of cases (77\%). Likely the transmission was human to human as
no animal contact was recorded. Five patients reported that they had
contact with a symptomatic family member, 3 returned to the UK from a
holiday (2 from Spain and 1 from a Mediterranean cruise). Eight patients
were admitted for other medical conditions and developed symptoms and
tested positive while in-hospital. Most of the patients (85\%) had
pre-existing comorbidities, with hypertension (45\%) most common,
followed by cardiovascular disease (34\%), chronic obstructive pulmonary
disease (33\%) and diabetes (23\%). Presenting symptoms and clinical
observations on the day of admission are displayed in Table 2.
Respiratory symptoms were the most common presenting complaint such as
fever (59\% of patients), shortness of breath (56\%) and cough (55\%).
Gastrointestinal symptoms were the second most common such as diarrhoea
(10\%) and abdominal pain (7\%). Most patients (66\%) were hypoxic and
required oxygen therapy on admission. Initial laboratory results and
imaging are displayed in Table 3. Leucocytosis associated with
lymphopenia was the most common laboratory abnormality. Opacifications
in chest X-rays were demonstrated in 32 patients. Seven patients had a
CT-chest due to worsening of their condition. All of the CT scans
demonstrated ground glass changes. All patients received supportive
treatment but no specific antiviral therapy was administered. Available
outcome data is displayed in Table 4. Patients who died ranged from
66-90 years old and were none significantly older than those who have
recovered and been discharged (average age 78.0 v 69.2 years, p=0.15)
but they had a significantly higher clinical frailty scores (5.75 v
3.36, p=0.005).

\textbf{Discussion}

We present the first UK clinical data of 71 cases of COVID-19 patients
admitted to one clinical centre. The majority of patients (70 patients)
were white British and one patient was Asian. Our cohort of patients of
mean (SD) age of 70.7 (16.6) years, with 75\% are [?]65 years, appears
older than the published Chinese cohort \{median age was only 46.0 years
and the proportion of older patients (\textgreater{} 60 years) was
44.1\%\}, we had slightly more men (58\% v 51.6\%) but the comorbidities
were similar. \textsuperscript{8} Around 10\% of our patients presented
with gastrointestinal symptoms such as diarrhoea compared to only 3.8\%
in a Chinese study. \textsuperscript{9} Although in another Chinese
study by Wang et al, 10\% of patients initially presented with nausea
and diarrhoea 1-2 days before the onset of fever and
dyspnoea.\textsuperscript{4} Laboratory systemic abnormalities
particularly lymphopenia and elevated CRP and chest imaging findings are
consistent with previously published literature. \textsuperscript{10}
The majority of our patients (55\%) had normal chest x-ray in comparison
to only around 18\% in a Chinese report. \textsuperscript{9} Our case
fatality rate of 14\% was similar to 8\% for those aged 70-79 and 14.8\%
for those [?]80 years that was reported from China. \textsuperscript{8}
Also, previously, older age has been reported as an important
independent predictor of mortality in SARS and MERS.
\textsuperscript{11, 12} Older people are more susceptible to infection
likely due to associated comorbidities and attenuation of the innate
immunity.\textsuperscript{13} The ageing immune system is characterized
by a low grade and chronic systemic inflammatory state or
``InflammAgeing'' and is associated with an increased susceptibility to
infection.\textsuperscript{14} One important finding in this case
series, which has not been reported yet in the literature, is the
emergence of frailty as a detrimental significant factor for poor
outcome in patients with COVID-19. Frailty is a syndrome that is
characterised by multisystem dysregulation that leads to reduced
physiologic reserve and increased risk of adverse health outcomes.
Dysregulation in the innate and adaptive immunity also leads to chronic
inflammation, with increase in inflammatory markers, and increased
susceptibility to severe infections. Increased inflammatory markers have
been shown in patients with viral pneumonia. \textsuperscript{13}
Although frailty was not formally assessed in the COVID-19 studies, the
fact that old age is associated with comorbidities and was associated
with an increased risk of COVID-19 infection and worse outcomes may
suggest underlying frailty was common in these old patients. The
strength of this case series is its prospective design which allowed
follow up of cases as well as the use of electronic record which allowed
accurate documentation of results. However, this study has few
limitations which include first, the small number included so far and
the incomplete conclusion of outcomes of the patients who are still
under treatment in hospital however, this series is in a continuous
follow up and successive publications will follow as more information
are gathered. Second, we were not able to record the incubation period
for the current infection as this was not clearly re-called by the
patients. Third, we are not able to report efficacy of any specific
antiviral therapy as per our hospital protocol, this has not been used.

\textbf{Conclusion}

This case series demonstrated that the characteristics of British
COVID-19 patients were generally similar to what is published so far in
literature although we report more gastrointestinal symptoms at
presentation and more normal chest X-ray findings in our cohort. We have
also identified frailty as an emergent risk factor for adverse outcome
in COVID-19 patients and suggest that it should be included in the
future vaccination recommendations.

\textbf{References}

1) Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan,
China, of Novel Coronavirus--Infected Pneumonia. NEJM 2020; 382:
1199-207.

2. COVID-19: epidemiology, virology and clinical features. GOV.UK. 2020
{[}Date of Access: 8 April 2020{]}. URL:
https://www.gov.uk/government/publications/wuhan-novel-coronavirus-background-information/wuhan-novel-coronavirus-epidemiology-virology-and-clinical-features.

3. Q\&A: Similarities and differences -- COVID-19 and influenza. World
Health Organization 2020 {[}Date of Access: 8 April 2020{]}. URL:
https://www.who.int/news-room/q-a-detail/q-a-similarities-and-differences-covid-19-and-influenza

4. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138
Hospitalized Patients With 2019 Novel Coronavirus--Infected Pneumonia in
Wuhan, China. JAMA 2020; 323: 1061. URL:
https://www.ncbi.nlm.nih.gov/pubmed/32031570.

5. Wu Z, McGoogan J. Characteristics of and Important Lessons From the
Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA 2020; 323:
1239. Available from:
https://jamanetwork.com/journals/jama/fullarticle/2762130.

6. COVID-19: investigation and initial clinical management of possible
cases {[}Internet{]}. GOV.UK. 2020 {[}cited 8 April 2020{]}. Available
from:
https://www.gov.uk/government/publications/wuhan-novel-coronavirus-initial-investigation-of-possible-cases/investigation-and-initial-clinical-management-of-possible-cases-of-wuhan-novel-coronavirus-wn-cov-infection

7. K. Rockwood et al. A global clinical measure of fitness and frailty
in elderly people. CMAJ 2005; 173: 489-95.

8. The novel coronavirus pneumonia emergency response epidemiology team.
The epidemiological characteristics of an outbreak of 2019 novel
coronavirus diseases (COVID-19) ---China, 2020. China CDC Weekly. 2020;
2: 113-22.

9. Guan W, Ni Z, HU Y, et al. Clinical Characteristics of Coronavirus
Disease 2019 in China. NEJM 2020; DOI: 10.1056/NEJMoa2002032.

10. Huang C, Wang Y, Li X, et al. Clinical features of patients infected
with 2019 novel

coronavirus in Wuhan, China. Lancet 2020; 395: 497-506.

11. Choi KW, Chau TN, Tsang O, et al. Outcomes and prognostic factors in
267 patients with severe acute respiratory syndrome in Hong Kong. Ann
Intern Med 2003; 139: 715-23.

12. Hong K-H, Choi J-P, Hong S-H, et al. Predictors of mortality in
Middle East respiratory syndrome (MERS). Thorax 2018; 73: 286-9.

13. Guo L, Wei D, Zhang X, et al. Clinical Features Predicting Mortality
Risk in Patients With Viral Pneumonia: The MuLBSTA Score. Front
Microbiol 2019; 10: 2752.

14. Franceschi C, Bonafe M, Valensin S, et al. Inflamm-aging. An
evolutionary perspective on immunosenescence. Ann N Y Acad Sci 2000;
908: 244-54.\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
\textbf{Table 1: Patients Demographics.} & \textbf{Table 1: Patients
Demographics.} & \textbf{Table 1: Patients Demographics.} &
\textbf{Number of patients (\%)}\tabularnewline
\midrule
\endhead
\textbf{Personal Demographics} & & \textbf{Total number} & 71
patients\tabularnewline
& \textbf{Age (years)} & Mean (SD) & 70.7 (16.6)\tabularnewline
& & 18-64 & 18 (25)\tabularnewline
& & 65+ & 53 (75)\tabularnewline
& & Range & 24-97\tabularnewline
& \textbf{Sex} & Male & 41 (58)\tabularnewline
& \textbf{Race} & White British & 70 (98.6)\tabularnewline
& & Asian & 1 (1.4)\tabularnewline
& \textbf{CFS} & Mean (SD) & 4.1 (2)\tabularnewline
& & \textless{}5 & 42 (59)\tabularnewline
& & 5+ & 29 (41)\tabularnewline
& \textbf{Source} & Unknown & 55 (77)\tabularnewline
& & Hospital acquired & 8 (11)\tabularnewline
& & Family member & 5 (8)\tabularnewline
& & Recent travel & 3 (4)\tabularnewline
& \textbf{Pre-existing conditions} & Any & 60 (85)\tabularnewline
& & HTN & 32 (45)\tabularnewline
& & CVD & 24 (34)\tabularnewline
& & COPD & 23 (33)\tabularnewline
& & DM & 16 (23)\tabularnewline
& & Dementia & 10 (14)\tabularnewline
& & Renal disease & 9 (12.6)\tabularnewline
& & Liver disease & 5 (7)\tabularnewline
& \textbf{Smoking status} & Unknown & 38 (54)\tabularnewline
& & Ex-smoker & 20 (28)\tabularnewline
& & Never smoked & 13 (18)\tabularnewline
& & Current smoker & 0\tabularnewline
\bottomrule
\end{longtable}

CFS=Clinical frailty score, HTN=Hypertension, DM=Diabetes mellitus,

COPD=Chronic obstructive pulmonary disease, CVD=Cardiovascular disease.\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
\begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Table 2: Presenting symptoms and initial observations.}\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Table 2: Presenting symptoms and initial observations.}\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Table 2: Presenting symptoms and initial observations.}\strut
\end{minipage} & \begin{minipage}[b]{0.22\columnwidth}\raggedright\strut
\textbf{Number of Patients (\%)}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textbf{Clinical Presentation}\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textbf{Symptoms}\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Fever\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
42 (59)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
SOB\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
40 (56)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Cough\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
39 (55)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Fatigue\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
16 (23)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Phlegm\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
9 (12.6)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Vomiting\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
8 (11)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
New confusion\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
8 (11)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Diarrhoea\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
7 (9.8)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Generally unwell\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
7 (9.8)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Myalgia\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
6 (8.5)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Abdominal pain\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
5 (7)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Headache\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
4 (5.6)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Chest pain\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
4 (5.6)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Sore Throat\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
2 (2.8)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Fall\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
2 (2.8)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Collapse\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
2 (2.8)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Anosmia\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
2 (2.8)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Poor oral intake\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
1 (1.4)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Haemoptysis\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
1 (1.4)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
Change in taste\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
1 (1.4)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\textbf{Initial Observations}\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\textbf{Temperature} \textbf{(Celsius)}\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\textless{}37.5\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
29 (41)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
37.5+\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
42 (59)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textbf{Oxygen Sats}\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textless{}96\%\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
47 (66)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
96\%+\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
24 (34)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textbf{RR}\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textless{}20\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
18 (25)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
20+\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
53 (75)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\textbf{Systolic BP} \textbf{(mmHg)}\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
\textless{}120\strut
\end{minipage} & \begin{minipage}[t]{0.24\columnwidth}\raggedright\strut
21 (29.5)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
120+\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
50 (70.5)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textbf{HR}\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\textless{}100\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
48 (67.7)\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
100+\strut
\end{minipage} & \begin{minipage}[t]{0.22\columnwidth}\raggedright\strut
23 (32.3)\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

SOB=Shortness of breath, RR=Respiratory rate, Sats=Saturation, BP=Blood
pressure,

HR=Heart rate.\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\textbf{Table 3: Lab results and imaging.} & \textbf{Table 3: Lab
results and imaging.} & \textbf{Table 3: Lab results and imaging.} &
\textbf{Mean (SD)} & \textbf{Range}\tabularnewline
\midrule
\endhead
\textbf{Investigations} & \textbf{Blood results} & Total WCC & 7.90
(4.1) & 1.1-22.1\tabularnewline
& & Neutrophil & 6.49 (3.8) & 0.7-19\tabularnewline
& & Lymphocyte & 0.81 (0.52) & 0.2-2.6\tabularnewline
& & Eosinophil & 0.021 (0.07) & 0-0.4\tabularnewline
& & Hb & 132.34 (23.6) & 57-187\tabularnewline
& & Creatinine & 111.1 (72.9) & 34-444\tabularnewline
& & Urea & 11.5 (8.8) & 2.8-62\tabularnewline
& & Na\textsuperscript{+} & 136.2 (6.6) & 120-166\tabularnewline
& & K\textsuperscript{+} & 4.4 (1.04) & 3.2-10\tabularnewline
& & ALT & 46.4 (36.6) & 7-193\tabularnewline
& & AST & 74.2 (56.3) & 12-253\tabularnewline
& & CRP & 112.7 (86.2) & 0.7-396\tabularnewline
& & & \textbf{Number of patients (\%)} & \textbf{Number of patients
(\%)}\tabularnewline
& \textbf{Chest-XR} & Clear & 39 (55) & 39 (55)\tabularnewline
& & Unilateral consolidation & 6 (8) & 6 (8)\tabularnewline
& & B/L consolidation & 26 (37) & 26 (37)\tabularnewline
& & CT chest & 7 (10) & 7 (10)\tabularnewline
\bottomrule
\end{longtable}

WCC=White cell count, Hb=Haemoglobin, ALT=Alanine aminotransferase,
AST=Aspartate aminotransferase, CRP=C-reactive protein, XR=X-Ray,
CT=Computerised tomography, B/L=Bilateral.\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
& & \textbf{Outcomes} & \textbf{Outcomes} &
\textbf{Outcomes}\tabularnewline
\midrule
\endhead
\textbf{Table 4: Patients outcomes} & \textbf{Table 4: Patients
outcomes} & \textbf{Home} & \textbf{HDU/ICU} &
\textbf{Death}\tabularnewline
& \textbf{Number (\%)} & 18 (25) & 9 (13) & 10 (14)\tabularnewline
\textbf{Average} & \textbf{Age (years)} & 69.2 & 61.2 &
78\tabularnewline
& \textbf{Clinical frailty score*} & 3.36 & 2.56 & 5.75\tabularnewline
& \textbf{Total WCC} & 8.89 & 9.28 & 5.46\tabularnewline
& \textbf{Neutrophil} & 7.26 & 8.1 & 4.33\tabularnewline
& \textbf{Lymphocytes} & 0.87 & 0.73 & 0.58\tabularnewline
& & \textbf{Outcomes (\%)} & \textbf{Outcomes (\%)} & \textbf{Outcomes
(\%)}\tabularnewline
& & \textbf{Home} & \textbf{HDU/ITU} & \textbf{Death}\tabularnewline
\textbf{Number of patients} & \textbf{No co-morbidities} & 4 (22) & 4
(44) & 0\tabularnewline
& \textbf{Any co-morbidities} & 14 (78) & 5 (56) & 10
(100)\tabularnewline
& \textbf{Any XR findings} & 15 (21) & 9 (100) & 6 (60)\tabularnewline
& \textbf{Normal XR} & 3 (17) & 0 & 4 (40)\tabularnewline
& \textbf{Needed oxygen} & 11 (61) & 7 (78) & 6 (60)\tabularnewline
\bottomrule
\end{longtable}

HDU/ICU=High-dependency unit/intensive care unit, *significant.

\selectlanguage{english}
\FloatBarrier
\end{document}

