Trajectories of Hospitalization in COVID-19 Patients: An Observational Study in France

Abstract

Describing the characteristics of COVID-19 patients in the hospital is of importance to assist in the management of hospital capacity in the future. Here, we analyze the trajectories of 1321 patients admitted to hospitals in northern and eastern France. We found that the time from onset to hospitalization decreased with age, from 7.3 days in the 20–65 year-olds to 4.5 in the >80 year-olds (p < 0.0001). Overall, the length of stay in the hospital was 15.9 days, and the death rate was 20%. One patient out of four was admitted to the intensive care unit (ICU) for approximately one month. The characteristics of trajectories changed with age: fewer older patients were admitted to the ICU and the death rate was larger in the elderly. Admission shortly after onset was associated with increased mortality (odds-ratio (OR) = 1.8, Confidence Interval (CI) 95% [1.3, 2.6]) as well as male sex (OR = 2.1, CI 95% [1.5, 2.9]). Time from admission within the hospital to the transfer to ICU was short. The age- and sex-adjusted mortality rate decreased over the course of the epidemic, suggesting improvement in care over time. In the SARS-CoV-2 epidemic, the urgent need for ICU at admission and the prolonged length of stay in ICU are a challenge for bed management and organization of care.

Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study

“…Of interest, the high mortality risk of elderly adults was consistently observed in China, European regions, and North America ( Figure 2 ). Indeed, similar findings have been consistently reported by single-country studies of COVID-19 patients in many countries such as America [ 12 ], Belgium [ 13 ], Canada [ 14 ], France [ 15 ], Germany [ 16 ], Italy [ 17 ], Mexico [ 18 ], Poland [ 19 ], Romania [ 20 ], Russia [ 21 ], Spain [ 22 ], and the United Kingdom [ 23 ]. Of note, age, gender, and chronic comorbidities are key factors that determine hospitalization rather than outpatient care [ 10 ].…”

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

“…In this study, we assessed the clinical characteristics at the admission of patients with more severe infections admitted to our hospital in the first wave of the COVID-19 pandemic. The overall proportion of deaths was 32%, much higher than that observed in China [ 4 , 5 ], similar to that reported in other areas of Spain [ 6 , 7 , 8 ] and neighboring European countries [ 9 , 10 ], and lower than that reported in United States [ 11 ], for the same age ranges. The threshold of severity required for hospitalization could explain some of these differences, as too could the incomplete follow up of patients assessed in some studies.…”

Clinical Factors Associated with Atrial Fibrillation Detection on Single-Time Point Screening Using a Hand-Held Single-Lead ECG Device

“…As a consequence of the disruptive effects of COVID-19 pandemic, screening for AF may become even more important in the next future. Indeed, COVID-19 caused a polarization of care on the various manifestation of SARS-CoV-2 infection and on its management [39][40][41] that coupled with the fear and psychological distress diffused within the population [42][43][44][45] led to a marked reduction in access to Emergency Departments for acute cardiovascular conditions, including new-onset AF [46][47][48][49][50]. Some data from large datasets indicate that the risk of undiagnosed AF during COVID-19 lockdown is associated with an increased occurrence of stroke, related to lack of anticoagulation in patients at risk [48], thus making of great clinical value any initiatives of opportunistic screening for detecting unknown and previously undetected AF.…”