Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19 Journal Articles uri icon

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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.

authors

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  • 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
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  • 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
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  • Villoldo, Andrea
  • Vishwanathan, Gayatri
  • Visseaux, Benoit
  • Visser, Hannah
  • Vitiello, Chiara
  • Vonkeman, Harald
  • Vuotto, Fanny
  • Wahab, Suhaila Abdul
  • Wahab, Noor Hidayu
  • Wahid, Nadirah Abdul
  • Wainstein, Marina
  • Shukeri, Wan Fadzlina Wan Muhd
  • Wang, Chih-Hsien
  • Webb, Steve
  • Weil, Katharina
  • Wen, Tan Pei
  • Wesselius, Sanne
  • West, T Eoin
  • Wham, Murray
  • Whelan, Bryan
  • White, Nicole
  • Wicky, Paul Henri
  • Wiedemann, Aurélie
  • Wijaya, Surya Otto
  • Wille, Keith
  • Willems, Suzette
  • Williams, Virginie
  • Wong, Calvin
  • Wong, Yew Sing
  • Wong, Teck Fung
  • Wright, Natalie
  • Xian, Gan Ee
  • Xian, Lim Saio
  • Xuan, Kuan Pei
  • Xynogalas, Ioannis
  • Yakop, Siti Rohani Binti Mohd
  • Yamazaki, Masaki
  • Yazdanpanah, Yazdan
  • Hing, Nicholas Yee Liang
  • Yelnik, Cécile
  • Yeoh, Chian Hui
  • Yerkovich, Stephanie
  • Yokoyama, Toshiki
  • Yonis, Hodane
  • Yousif, Obada
  • Yuliarto, Saptadi
  • Zaaqoq, Akram
  • Zabbe, Marion
  • Zacharowski, Kai
  • Zahid, Masliza
  • Zahran, Maram
  • Zaidan, Nor Zaila Binti
  • Zambon, Maria
  • Zambrano, Miguel
  • Zanella, Alberto
  • Zawadka, Konrad
  • Zaynah, Nurul
  • Zayyad, Hiba
  • Zoufaly, Alexander
  • Zucman, David

publication date

  • April 19, 2023