Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19. (28th February 2023)

• Record Type: Journal Article
• Authors: Kartsonaki, Christiana; Baillie, J Kenneth; Barrio, Noelia García; Baruch, Joaquín; Beane, Abigail; Blumberg, Lucille; Bozza, Fernando; Broadley, Tessa; Burrell, Aidan; Carson, Gail; Citarella, Barbara Wanjiru; Dagens, Andrew; Dankwa, Emmanuelle A; Donnelly, Christl A; Dunning, Jake; Elotmani, Loubna; Escher, Martina; Farshait, Nataly; Goffard, Jean-Christophe; Gonçalves, Bronner P; Hall, Matthew; Hashmi, Madiha; Sim Lim Heng, Benedict; Ho, Antonia; Jassat, Waasila; Pedrera Jiménez, Miguel; Laouenan, Cedric; Lissauer, Samantha; Martin-Loeches, Ignacio; Mentré, France; Merson, Laura; Morton, Ben; Munblit, Daniel; Nekliudov, Nikita A; Nichol, Alistair D; Singh Oinam, Budha Charan; Ong, David; Panda, Prasan Kumar; Petrovic, Michele; Pritchard, Mark G; Ramakrishnan, Nagarajan; Ramos, Grazielle Viana; Roger, Claire; Sandulescu, Oana; Semple, Malcolm G; Sharma, Pratima; Sigfrid, Louise; Somers, Emily C; Streinu-Cercel, Anca; Taccone, Fabio; Vecham, Pavan Kumar; Kumar Tirupakuzhi Vijayaraghavan, Bharath; Wei, Jia; Wils, Evert-Jan; Ci Wong, Xin; Horby, Peter; Rojek, Amanda; Olliaro, Piero L;
• Is Part Of: International journal of epidemiology. Volume 52:Number 2(2023)
• Page Start: 355
• Page End: 376
• Publication Date: 2023-02-28
• Subjects: COVID-19 -- SARS-CoV-2 -- cohort study -- risk of death -- co-morbidities -- symptoms -- treatments; Epidemiology -- Periodicals; 614.4
• DOI: 10.1093/ije/dyad012
• Languages: English
• ISSNs: 0300-5771

Abstract

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.