Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study

AbstractObjectiveTo characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respiratory and emerging Infections Co...

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Vydáno v:BMJ (Online) Ročník 369; s. m1985
Hlavní autoři: Docherty, Annemarie B, Harrison, Ewen M, Green, Christopher A, Hardwick, Hayley E, Pius, Riinu, Norman, Lisa, Holden, Karl A, Read, Jonathan M, Dondelinger, Frank, Carson, Gail, Merson, Laura, Lee, James, Plotkin, Daniel, Sigfrid, Louise, Halpin, Sophie, Jackson, Clare, Gamble, Carrol, Horby, Peter W, Nguyen-Van-Tam, Jonathan S, Ho, Antonia, Russell, Clark D, Dunning, Jake, Openshaw, Peter JM, Baillie, J Kenneth, Semple, Malcolm G
Médium: Journal Article
Jazyk:angličtina
Vydáno: England British Medical Journal Publishing Group 22.05.2020
BMJ Publishing Group LTD
BMJ Publishing Group Ltd
Témata:
Adolescent
Adult
Age
Age Factors
Aged
Aged, 80 and over
Asthma
Betacoronavirus
Child
Child, Preschool
Cohort analysis
Comorbidity
Coronary artery disease
Coronavirus Infections - epidemiology
Coronavirus Infections - mortality
Coronaviruses
COVID-19
Critical Care
Diabetes
Diabetes mellitus
Epidemics
Female
Heart diseases
Hospitalization
Hospitals
Humans
Infant
Infant, Newborn
Infections
Intensive care
Intensive care units
Kidney diseases
Liver diseases
Lung diseases
Male
Mechanical ventilation
Medical research
Middle Aged
Mortality
Obesity
Observational studies
Outbreaks
Pandemics
Pathogens
Patients
Pneumonia, Viral - epidemiology
Pneumonia, Viral - mortality
Portfolio management
Prospective Studies
Public health
Respiration, Artificial
Risk Factors
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Sex Factors
United Kingdom - epidemiology
Young Adult
United Kingdom
England
Scotland
United Kingdom > UK
United States > US
Wales
ISSN:1756-1833, 0959-8138, 1756-1833
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Shrnutí:AbstractObjectiveTo characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study, and to explore risk factors associated with mortality in hospital.DesignProspective observational cohort study with rapid data gathering and near real time analysis.Setting208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020. A case report form developed by ISARIC and WHO was used to collect clinical data. A minimal follow-up time of two weeks (to 3 May 2020) allowed most patients to complete their hospital admission.Participants20 133 hospital inpatients with covid-19.Main outcome measuresAdmission to critical care (high dependency unit or intensive care unit) and mortality in hospital.ResultsThe median age of patients admitted to hospital with covid-19, or with a diagnosis of covid-19 made in hospital, was 73 years (interquartile range 58-82, range 0-104). More men were admitted than women (men 60%, n=12 068; women 40%, n=8065). The median duration of symptoms before admission was 4 days (interquartile range 1-8). The commonest comorbidities were chronic cardiac disease (31%, 5469/17 702), uncomplicated diabetes (21%, 3650/17 599), non-asthmatic chronic pulmonary disease (18%, 3128/17 634), and chronic kidney disease (16%, 2830/17 506); 23% (4161/18 525) had no reported major comorbidity. Overall, 41% (8199/20 133) of patients were discharged alive, 26% (5165/20 133) died, and 34% (6769/20 133) continued to receive care at the reporting date. 17% (3001/18 183) required admission to high dependency or intensive care units; of these, 28% (826/3001) were discharged alive, 32% (958/3001) died, and 41% (1217/3001) continued to receive care at the reporting date. Of those receiving mechanical ventilation, 17% (276/1658) were discharged alive, 37% (618/1658) died, and 46% (764/1658) remained in hospital. Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital.ConclusionsISARIC WHO CCP-UK is a large prospective cohort study of patients in hospital with covid-19. The study continues to enrol at the time of this report. In study participants, mortality was high, independent risk factors were increasing age, male sex, and chronic comorbidity, including obesity. This study has shown the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.Study registrationISRCTN66726260.
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ISSN:1756-1833
0959-8138
1756-1833
DOI:10.1136/bmj.m1985