Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

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.

Chest CT findings and outcomes of COVID-19 in second wave: A cross-sectional study in a tertiary care centre in Northern India

“…This study found that diabetes was the most common comorbidity, present in 31.9% of all patients, followed by hypertension at 18%. Several studies have found that patients with pre-existing conditions such as diabetes, hypertension, cardiovascular diseases, and chronic respiratory diseases are at an increased risk of severe COVID-19 disease (16,18), but their association with worsened radiological scores or mortality was not found in this study and the literature on this aspect has been conflicting. This study also found that patients who received steroids on day 2 or who received remdesivir had a significantly lower CT score, indicating less lung damage.…”

Prognostische Faktoren bei einem schrittweisen Ansatz zur nicht-pharmakologischen Therapie von Sauerstoff und mechanischer Beatmung bis hin zur extrakorporalen Membranoxygenierung bei COVID-19

“…Sowohl Beobachtungsstudien kleinerer Kohorten [2-8] als auch groß angelegte Analysen zentraler Patientendatenbanken mit internationalem Vergleich [9][10][11] haben eine Fülle von Informationen über Risikofaktoren für schwere COVID-19-Verläufe geliefert. Eine im Februar 2023 veröffentlichte Arbeit mit Daten aus 52 Ländern von fast 700.000 Patienten beschreibt v. a. das hohe Alter als Hauptrisikofaktor für einen letalen Krankheitsverlauf, gefolgt von Rauchen und Adipositas [10]. Erhöhtes Lebensalter, männliches Geschlecht sowie kardiometabolische Faktoren (kardiovaskuläre Erkrankungen, arterielle Hypertonie und Diabetes) wurden wiederholt als Risikofaktoren identifiziert.…”

Implementation of Recommendations on the Use of Corticosteroids in Severe COVID-19

“…10 We undertook an analysis of observational data from the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC). [11][12][13][14] The main objective of this cohort study was to compare variations over time and across WHO regions of corticosteroid use for severe COVID-19. The first secondary objective was to evaluate the association between publication of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial 15 and of the WHO guidelines 2 and the temporal trends in corticosteroid use by region.…”

“…We undertook an analysis of observational data from the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) . The main objective of this cohort study was to compare variations over time and across WHO regions of corticosteroid use for severe COVID-19.…”