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

Autor:	Kartsonaki C; Medical Research Council (MRC) Population Health Research Unit, Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Baillie JK; Roslin Institute, University of Edinburgh, Edinburgh, UK.; Intensive Care Unit, Royal Infirmary of Edinburgh, Edinburgh, UK., Barrio NG; Hospital 12 de Octubre, Madrid, Spain., Baruch J; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Beane A; Critical Care Asia, Bangkok, Thailand., Blumberg L; National Institute for Communicable Diseases, Johannesburg, South Africa., Bozza F; National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (INI-FIOCRUZ), Ministry of Health, and D'Or Institute of Research and Education (IDOR), Rio de Janeiro, São Paulo, Brazil., Broadley T; Monash University, Clayton, Melbourne, Australia., Burrell A; Monash University, Clayton, Melbourne, Australia., Carson G; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Citarella BW; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Dagens A; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Dankwa EA; Department of Statistics, University of Oxford, Oxford, UK., Donnelly CA; Department of Statistics, University of Oxford, Oxford, UK.; MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics and Department of Infectious Disease Epidemiology, Imperial College London, London, UK., Dunning J; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Elotmani L; CHU Caremeau, Nîmes, France., Escher M; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Farshait N; Humber River Hospital, Toronto, Canada., Goffard JC; Cliniques Universitaires de Bruxelles (CUB) Hopital Erasme, Anderlecht, Belgium., Gonçalves BP; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Hall M; Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Hashmi M; Critical Care Asia and Ziauddin University, Karachi, Pakistan., Sim Lim Heng B; Hospital Sungai Buloh, Ministry of Health, Sungai Buloh, Malaysia., Ho A; Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, UK Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, UK., Jassat W; National Institute for Communicable Diseases, Johannesburg, South Africa., Pedrera Jiménez M; Hospital 12 de Octubre, Madrid, Spain., Laouenan C; Un iversité de Paris, France, Infection, Antimicrobials, Modelling, Evolution (IAME), INSERM, Paris, France., Lissauer S; Malawi-Liverpool Wellcome Trust, Blantyre, Malawi., Martin-Loeches I; St James's Hospital, Dublin, Ireland., Mentré F; Un iversité de Paris, France, Infection, Antimicrobials, Modelling, Evolution (IAME), INSERM, Paris, France., Merson L; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Infectious Diseases Data Observatory, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK., Morton B; Liverpool School of Tropical Medicine, Liverpool, UK., Munblit D; Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.; Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK., Nekliudov NA; Sechenov University, Moscow, Russia., Nichol AD; Irish Critical Care Critical Clinical Trials Network, Dublin, Ireland., Singh Oinam BC; All India Institute of Medical Sciences (AIIMS), Rishikesh, India., Ong D; Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands., Panda PK; All India Institute of Medical Sciences (AIIMS), Rishikesh, India., Petrovic M; Humber River Hospital, Toronto, Canada., Pritchard MG; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Ramakrishnan N; Apollo Hospitals Chennai, Chennai, India., Ramos GV; National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation (INI-FIOCRUZ), Ministry of Health, and D'Or Institute of Research and Education (IDOR), Rio de Janeiro, São Paulo, Brazil., Roger C; CHU Caremeau, Nîmes, France., Sandulescu O; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.; National Institute for Infectious Diseases 'Prof. Dr. Matei Bals', Bucharest, Romania., Semple MG; Institute of Infection, Veterinary and Ecological Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.; UK Respiratory Medicine, Alder Hey Children's NHS Foundation Trust, Liverpool, UK., Sharma P; University of Michigan Schools of Medicine & Public Health, Ann Arbor, Michigan, USA., Sigfrid L; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Somers EC; University of Michigan Schools of Medicine & Public Health, Ann Arbor, Michigan, USA., Streinu-Cercel A; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania., Taccone F; Cliniques Universitaires de Bruxelles (CUB) Hopital Erasme, Anderlecht, Belgium., Vecham PK; Apollo Hospitals Chennai, Chennai, India., Kumar Tirupakuzhi Vijayaraghavan B; Department of Critical Care Medicine, Apollo Hospitals, Chennai, India.; The George Institute for Global Health, New Delhi, India., Wei J; Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Wils EJ; Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands., Ci Wong X; National Institutes of Health (NIH), Ministry of Health, Shah Alam, Malaysia., Horby P; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK., Rojek A; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Royal Melbourne Hospital, Melbourne, Australia.; Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia., Olliaro PL; International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) Global Support Centre, Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Jazyk:	angličtina
Zdroj:	International journal of epidemiology [Int J Epidemiol] 2023 Apr 19; Vol. 52 (2), pp. 355-376.
DOI:	10.1093/ije/dyad012
Abstrakt:	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. (© The Author(s) 2023. Published by Oxford University Press on behalf of the International Epidemiological Association.)
Databáze:	MEDLINE
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