Trends and associated factors for Covid-19 hospitalisation and fatality risk in 2.3 million adults in England

Beaney, Thomas; Neves, Ana Luísa; Alboksmaty, Ahmed; Ashrafian, Hutan; Flott, Kelsey; Fowler, Aidan; Benger, Jonathan; Aylin, Paul; Elkin, Sarah; Darzi, Ara; Clarke, Jonathan

doi:10.1038/s41467-022-29880-7

Cited by 33 publications

(32 citation statements)

References 16 publications

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“…We reproduced the expected impact of age and comorbidities on COVID-19 severity. However, we did not find a significant effect of gender on COVID-19 severity, whereas other studies have found that the fatality rates are higher for men than in women (Beaney et al 2022), risk differences by gender have been shown to vary considerably with geography and time, suggesting that this interaction is mediated by social rather than biological factors (Danielsen et al 2022) and highlighting the benefits of studying epidemics in different populations That we found an increased risk of severe COVID-19 among certain non-citizen residents of Bahrain (`Other` category, Table 2), and within one of five governantes (Muharraq) indicates some degree of demographic heterogeneity of risk within the Bahraini population. Interestingly, the fact that South Asian patients had no detectable increased risk of severe disease, and that many South Asians in Bahrain are migrant workers, may mean that correlates of migrant worker status were not important determinants of COVID-19 outcomes.…”

Section: Discussioncontrasting

confidence: 99%

Demographic and Viral-Genetic Analyses of COVID-19 Severity in Bahrain Identify Local Risk Factors and a Protective Effect of Polymerase Mutations

Koch

Dressner

et al. 2022

Preprint

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A multitude of demographic, health, and genetic factors are associated with the risk of developing severe COVID-19 following infection by the SARS-CoV-2. There is a need to perform studies across human societies and to investigate the full spectrum of genetic variation of the virus. Using data from 869 COVID-19 patients in Bahrain between March 2020 and March 2021, we analyzed paired viral sequencing and non-genetic host data to understand host and viral determinants of severe COVID-19. We estimated the effects of demographic variables specific to the Bahrain population and found that the impact of health factors are largely consistent with other populations. To extend beyond the common variants of concern in the Spike protein analyzed by previous studies, we used a viral burden approach and detected a protective effect of low-frequency missense viral mutations in the RNA-dependent RNA polymerase (Pol) gene on disease severity. Our results contribute to the survey of severe COVID-19 in diverse populations and highlight the benefits of studying rare viral mutations.

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Section: Discussioncontrasting

confidence: 99%

Demographic and Viral-Genetic Analyses of COVID-19 Severity in Bahrain Identify Local Risk Factors and a Protective Effect of Polymerase Mutations

Koch

Dressner

et al. 2022

Preprint

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“…1 In children, SARS‐CoV‐2 infections are typically asymptomatic or associated with mild disease, and hospitalisation is uncommon. 2 , 3 Correspondingly, mortality is lower than in adults; the estimated infection fatality rate for people under 18 years of age in England during 2020–21 was five deaths per 100 000 infections 4 (adults: 2300 deaths per 100 000 infections 5 ).…”

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confidence: 99%

COVID ‐19 in New South Wales children during 2021: severity and clinical spectrum

Williams

Koirala

Saravanos

et al. 2022

Medical Journal of Australia

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Objectives: To describe the severity and clinical spectrum of coronavirus disease 2019 (COVID‐19) in children during the 2021 New South Wales outbreak of the Delta variant of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Design, setting: Prospective cohort study in three metropolitan Sydney local health districts, 1 June – 31 October 2021. Participants: Children under 16 years of age with positive SARS‐CoV‐2 nucleic acid test results admitted to hospital or managed by the Sydney Children’s Hospital Network (SCHN) virtual care team. Main outcome measures: Age‐specific SARS‐CoV‐2 infection frequency, overall and separately for SCHN virtual and hospital patients; rates of medical and social reason admissions, intensive care admissions, and paediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2 per 100 SARS‐CoV‐2 infections; demographic and clinical factors that influenced likelihood of hospital admission. Results: A total of 17 474 SARS‐CoV‐2 infections in children under 16 were recorded in NSW, of whom 11 985 (68.6%) received SCHN‐coordinated care, including 459 admitted to SCHN hospitals: 165 for medical reasons (1.38 [95% CI, 1.17–1.59] per 100 infections), including 15 admitted to intensive care, and 294 (under 18 years of age) for social reasons (2.45 [95% CI, 2.18–2.73] per 100 infections). In an analysis that included all children admitted to hospital and a random sample of those managed by the virtual team, having another medical condition (adjusted odds ratio [aOR], 7.42; 95% CI, 3.08–19.3) was associated with increased likelihood of medical admission; in univariate analyses, non‐asthmatic chronic respiratory disease was associated with greater (OR, 9.21; 95% CI, 1.61–174) and asthma/viral induced wheeze with lower likelihood of admission (OR, 0.38; 95% CI, 0.18–0.78). The likelihood of admission for medical reasons declined from infancy to 5–11 years, but rose again for those aged 12–15 years. Sex and Indigenous status did not influence the likelihood of admission. Conclusion: Most SARS‐CoV‐2 infections (Delta variant) in children were asymptomatic or associated with mild disease. Hospitalisation was relatively infrequent, and most common for infants, adolescents, and children with other medical conditions. More children were hospitalised for social than for medical reasons.

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“…Unlike in adults, whom have a higher risk of developing aggressive forms of disease, and require more hospitalization days, most of the children in our study needed less than 5 days of hospital admission [12]. Furthermore, here occurs another reason for this short hospitalization of the included infants and children, 52.63% of mothers or caregivers decided that they want a discharge on request, contrary to the advice of the doctor.…”

Section: Discussionmentioning

confidence: 64%

COVID-19 in Infants and Children under 2 years – Lung Ultrasound Score Correlated with Biomarkers and Symptoms

Stoicescu¹,

Lovrenski²,

Iacob³

et al. 2022

Preprint

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It is already well known that infants and children infected with COVID-19 develop mild to mod-erate forms of the disease, with fever and oropharyngeal congestion being the most common symptoms. Nevertheless, there are cases in which the patients accuse respiratory symptoms. These cases need lung evaluation, which can be done using lung ultrasound (LUS), because it is a non-irradiating and repeatable imaging technique. 19 children with COVID-19 pneumonia were eval-uated using LUS. The LUS score (LUSS) for each patient varied between 1 to 8 points from a max-imum of 36 points. The arithmetic mean was 4.47 ± 2.36 (S.D), while 95% CI for the Arithmetic mean was 3.33 to 5.61. The lung changes were correlated with their biomarkers, specifically in-flammatory markers. The correlation between LUSS and LDH, D-dimers and IL-6 was a strong positive one with r=0.66 (p=0.01, 95% CI 0.147 to 0.896) between the LUSS and LDH level at symptomatic infants and children (with cough present) and r=0.66 (p=0.01, 95% CI 0.140 to 0.895) between LUSS and D-dimers level at symptomatic infants and children (with cough pre-sent). The results suggest that LUS could be a good imaging technique that can be used both in ini-tial evaluation of children with respiratory diseases, and, also in their follow-up, correlated with symptoms and biomarkers.

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Trends and associated factors for Covid-19 hospitalisation and fatality risk in 2.3 million adults in England

Cited by 33 publications

References 16 publications

Demographic and Viral-Genetic Analyses of COVID-19 Severity in Bahrain Identify Local Risk Factors and a Protective Effect of Polymerase Mutations

Demographic and Viral-Genetic Analyses of COVID-19 Severity in Bahrain Identify Local Risk Factors and a Protective Effect of Polymerase Mutations

COVID ‐19 in New South Wales children during 2021: severity and clinical spectrum

COVID-19 in Infants and Children under 2 years – Lung Ultrasound Score Correlated with Biomarkers and Symptoms

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