TY - JOUR
T1 - Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19
AU - ISARIC Clinical Characterisation Group
AU - Kartsonaki, Christiana
AU - Baillie, J. Kenneth
AU - Barrio, Noelia García
AU - Baruch, Joaquín
AU - Beane, Abigail
AU - Blumberg, Lucille
AU - Bozza, Fernando
AU - Broadley, Tessa
AU - Burrell, Aidan
AU - Carson, Gail
AU - Citarella, Barbara Wanjiru
AU - Dagens, Andrew
AU - Dankwa, Emmanuelle A.
AU - Donnelly, Christl A.
AU - Dunning, Jake
AU - Elotmani, Loubna
AU - Escher, Martina
AU - Farshait, Nataly
AU - Goffard, Jean Christophe
AU - Gonçalves, Bronner P.
AU - Hall, Matthew
AU - Hashmi, Madiha
AU - Heng, Benedict Sim Lim
AU - Ho, Antonia
AU - Jassat, Waasila
AU - Jiménez, Miguel Pedrera
AU - Laouenan, Cedric
AU - Lissauer, Samantha
AU - Martin-Loeches, Ignacio
AU - Mentré, France
AU - Merson, Laura
AU - Morton, Ben
AU - Munblit, Daniel
AU - Nekliudov, Nikita A.
AU - Nichol, Alistair D.
AU - Oinam, Budha Charan Singh
AU - Ong, David
AU - Panda, Prasan Kumar
AU - Petrovic, Michele
AU - Pritchard, Mark G.
AU - Ramakrishnan, Nagarajan
AU - Ramos, Grazielle Viana
AU - Roger, Claire
AU - Sandulescu, Oana
AU - Semple, Malcolm G.
AU - Sharma, Pratima
AU - Flynn, Deirdre
AU - Foley, Jean
AU - Kelsey, Maeve
AU - Manning, Edmund
N1 - Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - 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.
AB - 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.
KW - co-morbidities
KW - cohort study
KW - COVID-19
KW - risk of death
KW - SARS-CoV-2
KW - symptoms
KW - treatments
UR - https://www.scopus.com/pages/publications/85159603496
U2 - 10.1093/ije/dyad012
DO - 10.1093/ije/dyad012
M3 - Article
AN - SCOPUS:85159603496
SN - 0300-5771
VL - 52
SP - 355
EP - 376
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 2
ER -
SDG 3 Good Health and Well-being