tetano
Editor, Senior Moderator
Int J Epidemiol
. 2023 Feb 28;dyad012.
doi: 10.1093/ije/dyad012. Online ahead of print.
Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19
Christiana Kartsonaki[SUP] 1 [/SUP], J Kenneth Baillie[SUP] 2 3 [/SUP], Noelia García Barrio[SUP] 4 [/SUP], Joaquín Baruch[SUP] 5 [/SUP], Abigail Beane[SUP] 6 [/SUP], Lucille Blumberg[SUP] 7 [/SUP], Fernando Bozza[SUP] 8 [/SUP], Tessa Broadley[SUP] 9 [/SUP], Aidan Burrell[SUP] 9 [/SUP], Gail Carson[SUP] 5 [/SUP], Barbara Wanjiru Citarella[SUP] 5 [/SUP], Andrew Dagens[SUP] 5 [/SUP], Emmanuelle A Dankwa[SUP] 10 [/SUP], Christl A Donnelly[SUP] 10 11 [/SUP], Jake Dunning[SUP] 5 [/SUP], Loubna Elotmani[SUP] 12 [/SUP], Martina Escher[SUP] 5 [/SUP], Nataly Farshait[SUP] 13 [/SUP], Jean-Christophe Goffard[SUP] 14 [/SUP], Bronner P Gonçalves[SUP] 5 [/SUP], Matthew Hall[SUP] 15 [/SUP], Madiha Hashmi[SUP] 16 [/SUP], Benedict Sim Lim Heng[SUP] 17 [/SUP], Antonia Ho[SUP] 18 [/SUP], Waasila Jassat[SUP] 7 [/SUP], Miguel Pedrera Jiménez[SUP] 4 [/SUP], Cedric Laouenan[SUP] 19 [/SUP], Samantha Lissauer[SUP] 20 [/SUP], Ignacio Martin-Loeches[SUP] 21 [/SUP], France Mentré[SUP] 19 [/SUP], Laura Merson[SUP] 5 22 [/SUP], Ben Morton[SUP] 23 [/SUP], Daniel Munblit[SUP] 24 25 [/SUP], Nikita A Nekliudov[SUP] 26 [/SUP], Alistair D Nichol[SUP] 27 [/SUP], Budha Charan Singh Oinam[SUP] 28 [/SUP], David Ong[SUP] 29 [/SUP], Prasan Kumar Panda[SUP] 28 [/SUP], Michele Petrovic[SUP] 13 [/SUP], Mark G Pritchard[SUP] 5 [/SUP], Nagarajan Ramakrishnan[SUP] 30 [/SUP], Grazielle Viana Ramos[SUP] 8 [/SUP], Claire Roger[SUP] 12 [/SUP], Oana Sandulescu[SUP] 31 32 [/SUP], Malcolm G Semple[SUP] 33 34 [/SUP], Pratima Sharma[SUP] 35 [/SUP], Louise Sigfrid[SUP] 5 [/SUP], Emily C Somers[SUP] 35 [/SUP], Anca Streinu-Cercel[SUP] 31 [/SUP], Fabio Taccone[SUP] 14 [/SUP], Pavan Kumar Vecham[SUP] 30 [/SUP], Bharath Kumar Tirupakuzhi Vijayaraghavan[SUP] 36 37 [/SUP], Jia Wei[SUP] 15 [/SUP], Evert-Jan Wils[SUP] 29 [/SUP], Xin Ci Wong[SUP] 38 [/SUP], Peter Horby[SUP] 5 [/SUP], Amanda Rojek[SUP] 5 39 40 [/SUP], Piero L Olliaro[SUP] 5 [/SUP]; ISARIC Clinical Characterisation Group
Collaborators, Affiliations
Abstract
Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients.
Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV).
Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%.
Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.
Keywords: COVID-19; SARS-CoV-2; co-morbidities; cohort study; risk o
. 2023 Feb 28;dyad012.
doi: 10.1093/ije/dyad012. Online ahead of print.
Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19
Christiana Kartsonaki[SUP] 1 [/SUP], J Kenneth Baillie[SUP] 2 3 [/SUP], Noelia García Barrio[SUP] 4 [/SUP], Joaquín Baruch[SUP] 5 [/SUP], Abigail Beane[SUP] 6 [/SUP], Lucille Blumberg[SUP] 7 [/SUP], Fernando Bozza[SUP] 8 [/SUP], Tessa Broadley[SUP] 9 [/SUP], Aidan Burrell[SUP] 9 [/SUP], Gail Carson[SUP] 5 [/SUP], Barbara Wanjiru Citarella[SUP] 5 [/SUP], Andrew Dagens[SUP] 5 [/SUP], Emmanuelle A Dankwa[SUP] 10 [/SUP], Christl A Donnelly[SUP] 10 11 [/SUP], Jake Dunning[SUP] 5 [/SUP], Loubna Elotmani[SUP] 12 [/SUP], Martina Escher[SUP] 5 [/SUP], Nataly Farshait[SUP] 13 [/SUP], Jean-Christophe Goffard[SUP] 14 [/SUP], Bronner P Gonçalves[SUP] 5 [/SUP], Matthew Hall[SUP] 15 [/SUP], Madiha Hashmi[SUP] 16 [/SUP], Benedict Sim Lim Heng[SUP] 17 [/SUP], Antonia Ho[SUP] 18 [/SUP], Waasila Jassat[SUP] 7 [/SUP], Miguel Pedrera Jiménez[SUP] 4 [/SUP], Cedric Laouenan[SUP] 19 [/SUP], Samantha Lissauer[SUP] 20 [/SUP], Ignacio Martin-Loeches[SUP] 21 [/SUP], France Mentré[SUP] 19 [/SUP], Laura Merson[SUP] 5 22 [/SUP], Ben Morton[SUP] 23 [/SUP], Daniel Munblit[SUP] 24 25 [/SUP], Nikita A Nekliudov[SUP] 26 [/SUP], Alistair D Nichol[SUP] 27 [/SUP], Budha Charan Singh Oinam[SUP] 28 [/SUP], David Ong[SUP] 29 [/SUP], Prasan Kumar Panda[SUP] 28 [/SUP], Michele Petrovic[SUP] 13 [/SUP], Mark G Pritchard[SUP] 5 [/SUP], Nagarajan Ramakrishnan[SUP] 30 [/SUP], Grazielle Viana Ramos[SUP] 8 [/SUP], Claire Roger[SUP] 12 [/SUP], Oana Sandulescu[SUP] 31 32 [/SUP], Malcolm G Semple[SUP] 33 34 [/SUP], Pratima Sharma[SUP] 35 [/SUP], Louise Sigfrid[SUP] 5 [/SUP], Emily C Somers[SUP] 35 [/SUP], Anca Streinu-Cercel[SUP] 31 [/SUP], Fabio Taccone[SUP] 14 [/SUP], Pavan Kumar Vecham[SUP] 30 [/SUP], Bharath Kumar Tirupakuzhi Vijayaraghavan[SUP] 36 37 [/SUP], Jia Wei[SUP] 15 [/SUP], Evert-Jan Wils[SUP] 29 [/SUP], Xin Ci Wong[SUP] 38 [/SUP], Peter Horby[SUP] 5 [/SUP], Amanda Rojek[SUP] 5 39 40 [/SUP], Piero L Olliaro[SUP] 5 [/SUP]; ISARIC Clinical Characterisation Group
Collaborators, Affiliations
- PMID: 36850054
- DOI: 10.1093/ije/dyad012
Abstract
Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients.
Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV).
Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%.
Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.
Keywords: COVID-19; SARS-CoV-2; co-morbidities; cohort study; risk o