Changes in COVID-19 in-hospital mortality in hospitalised adults in England over the first seven months of the pandemic: An observational study using administrative data

Gray, William K.; Navaratnam, Annakan; Day, Jamie; Wendon, Julia; Briggs, Tim

doi:10.1016/j.lanepe.2021.100104

Cited by 39 publications

(35 citation statements)

References 29 publications

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“…Cardiovascular diseases, endocrine, nutritional and metabolic diseases and COPD, as well as diseases of the genitourinary system were more frequently observed among those who died compared to those who survived. Our study is in line with previous studies on comorbidities among patients with COVID-19, however, the frequency of subsequent diseases differs across the studies due to different methodologies and populations [ 10 , 11 , 16 , 21 , 22 ]. In our study, 65% of patients hospitalized with COVID-19 had at least one comorbidity.…”

Section: Discussionsupporting

confidence: 91%

“…Among COVID-19 patients in Sweden, hypertension, type 2 diabetes mellitus, chronic renal failure, asthma, obesity, being a solid organ transplant recipient and immunosuppressant medications were independent risk factors of ICU admission [ 15 ]. A retrospective observational study using the Hospital Episode Statistics administrative dataset in England showed significant changes in COVID-19 in-hospital mortality in hospitalized adults over the first seven months of the pandemic (March–September 2020) [ 16 ]. Due to the health inequities between the countries and regions, differences in the healthcare systems and access to healthcare, detailed, national data on patient characteristics, treatment and outcomes of COVID-19 are needed to inform decision-makers and healthcare professionals about resource allocation and healthcare capacity.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and Clinical Outcomes of 116,539 Patients Hospitalized with COVID-19—Poland, March–December 2020

Gujski

Jankowski

Rabczenko

et al. 2021

Viruses

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19). This study aimed to characterize patients hospitalized with COVID-19 in Poland between March and December 2020, as well as to identify factors associated with COVID 19–related risk of in-hospital death. This retrospective analysis was based on data from the hospital discharge reports on COVID-19 patients hospitalized in Poland between March and December 2020. A total of 116,539 discharge reports on patients hospitalized with COVID-19 were analyzed. Among patients with COVID-19, 21,490 (18.4%) died during hospitalization. Patients over 60 years of age (OR = 7.74; 95%CI: 7.37–8.12; p < 0.001), men (OR = 1.42; 95%CI: 1.38–1.47; p < 0.001) as well as those with cardiovascular diseases (OR = 1.51; 95%CI: 1.46–1.56; p < 0.001) or disease of the genitourinary system (OR = 1.39; 95%CI: 1.31–1.47; p < 0.001) had much higher odds of COVID 19–related risk of in-hospital death. The presence of at least one comorbidity more than doubled the COVID 19–related risk of in-hospital death (OR = 2.23; 95%CI: 2.14–2.32; p < 0.01). The following predictors of admission to ICU were found in multivariable analysis: age over 60 years (OR: 2.03; 95%CI: 1.90–2.16), male sex (OR: 1.79; 95%CI: 1.69–1.89), presence of at least one cardiovascular disease (OR: 1.26; 95%CI: 1.19–1.34), presence of at least one endocrine, nutritional and metabolic disease (OR: 1.17; 95%CI: 1.07–1.28).

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Characteristics and Clinical Outcomes of 116,539 Patients Hospitalized with COVID-19—Poland, March–December 2020

Gujski

Jankowski

Rabczenko

et al. 2021

Viruses

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“…As reported previously, in-hospital mortality rates fell substantially during the early part of the first wave (March–May 2020) and remained low during summer and early autumn 2020. 4 5 The current study reveals that mortality rates rose steadily during late 2020, but stayed well below their first wave peak, and then declined during February–March 2021. This broadly supports earlier evidence from Public Health England of increasing mortality rates during late 2020, although the adjusted peak in mortality reported in our study is lower.…”

Section: Discussionmentioning

confidence: 58%

“…For black and mixed ethnic groups, our previous work found evidence that relatively high adjusted in-hospital mortality rates in March–May 2020 had declined to levels seen in white ethnicity patients by summer/autumn 2020. 4 These changes appear to have been maintained over the second wave. In contrast, adjusted in-hospital mortality rates in Asian (Bangladeshi, Pakistani, Indian and other Asian) ethnicity patients remained at higher levels than seen in white patients throughout the study period.…”

Section: Discussionmentioning

confidence: 93%

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COVID-19 hospital activity and in-hospital mortality during the first and second waves of the pandemic in England: an observational study

Gray¹,

Navaratnam²,

Day³

et al. 2021

Thorax

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IntroductionWe aimed to examine the profile of, and outcomes for, all people hospitalised with COVID-19 across the first and second waves of the pandemic in England.MethodsThis was an exploratory retrospective analysis of observational data from the Hospital Episode Statistics data set for England. All patients aged ≥18 years in England with a diagnosis of COVID-19 who had a hospital stay that was completed between 1 March 2020 and 31 March 2021 were included. In-hospital mortality was the primary outcome of interest. The second wave was identified as starting on 1 September 2020. Multilevel logistic regression modelling was used to investigate the relationship between mortality and demographic, comorbidity and temporal covariates.ResultsOver the 13 months, 374 244 unique patients had a diagnosis of COVID-19 during a hospital stay, of whom 93 701 (25%) died in hospital. Adjusted mortality rates fell from 40%–50% in March 2020 to 11% in August 2020 before rising to 21% in January 2021 and declining steadily to March 2021. Improvements in mortality rates were less apparent in older and comorbid patients. Although mortality rates fell for all ethnic groups from the first to the second wave, declines were less pronounced for Bangladeshi, Indian, Pakistani, other Asian and black African ethnic groups.ConclusionsThere was a substantial decline in adjusted mortality rates during the early part of the first wave which was largely maintained during the second wave. The underlying reasons for consistently higher mortality risk in some ethnic groups merits further study.

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Risk of COVID‐19 death for people with a pre‐existing cancer diagnosis prior to COVID‐19‐vaccination: A systematic review and meta‐analysis

Steinberg,

Hughes,

Hui

et al. 2023

Intl Journal of Cancer

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While previous reviews found a positive association between pre‐existing cancer diagnosis and COVID‐19‐related death, most early studies did not distinguish long‐term cancer survivors from those recently diagnosed/treated, nor adjust for important confounders including age. We aimed to consolidate higher‐quality evidence on risk of COVID‐19‐related death for people with recent/active cancer (compared to people without) in the pre‐COVID‐19‐vaccination period. We searched the WHO COVID‐19 Global Research Database (20 December 2021), and Medline and Embase (10 May 2023). We included studies adjusting for age and sex, and providing details of cancer status. Risk‐of‐bias assessment was based on the Newcastle‐Ottawa Scale. Pooled adjusted odds or risk ratios (aORs, aRRs) or hazard ratios (aHRs) and 95% confidence intervals (95% CIs) were calculated using generic inverse‐variance random‐effects models. Random‐effects meta‐regressions were used to assess associations between effect estimates and time since cancer diagnosis/treatment. Of 23 773 unique title/abstract records, 39 studies were eligible for inclusion (2 low, 17 moderate, 20 high risk of bias). Risk of COVID‐19‐related death was higher for people with active or recently diagnosed/treated cancer (general population: aOR = 1.48, 95% CI: 1.36‐1.61, I2 = 0; people with COVID‐19: aOR = 1.58, 95% CI: 1.41‐1.77, I2 = 0.58; inpatients with COVID‐19: aOR = 1.66, 95% CI: 1.34‐2.06, I2 = 0.98). Risks were more elevated for lung (general population: aOR = 3.4, 95% CI: 2.4‐4.7) and hematological cancers (general population: aOR = 2.13, 95% CI: 1.68‐2.68, I2 = 0.43), and for metastatic cancers. Meta‐regression suggested risk of COVID‐19‐related death decreased with time since diagnosis/treatment, for example, for any/solid cancers, fitted aOR = 1.55 (95% CI: 1.37‐1.75) at 1 year and aOR = 0.98 (95% CI: 0.80‐1.20) at 5 years post‐cancer diagnosis/treatment. In conclusion, before COVID‐19‐vaccination, risk of COVID‐19‐related death was higher for people with recent cancer, with risk depending on cancer type and time since diagnosis/treatment.

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Changes in COVID-19 in-hospital mortality in hospitalised adults in England over the first seven months of the pandemic: An observational study using administrative data

Cited by 39 publications

References 29 publications

Characteristics and Clinical Outcomes of 116,539 Patients Hospitalized with COVID-19—Poland, March–December 2020

Characteristics and Clinical Outcomes of 116,539 Patients Hospitalized with COVID-19—Poland, March–December 2020

COVID-19 hospital activity and in-hospital mortality during the first and second waves of the pandemic in England: an observational study

Risk of COVID‐19 death for people with a pre‐existing cancer diagnosis prior to COVID‐19‐vaccination: A systematic review and meta‐analysis

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