Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study
<p><strong>OBJECTIVE:</strong> To characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respir...
| Asıl Yazarlar: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Materyal Türü: | Journal article |
| Dil: | English |
| Baskı/Yayın Bilgisi: |
BMJ Publishing Group
2020
|
| _version_ | 1826258489538772992 |
|---|---|
| author | Docherty, AB Harrison, EW Green, CA Hardwick, HE Pius, R Norman, L Holden, KA Read, JM Dondelinger, F Carson, G Merson, L Lee, J Plotkin, D Sigfrid, L Halpin, S Jackson, C Gamble, C Horby, PW Nguyen-Van-Tam, JS Ho, A Russell, CD Dunning, J Openshaw, PJ Baillie, JK Semple, MG ISARIC4C investigators |
| author_facet | Docherty, AB Harrison, EW Green, CA Hardwick, HE Pius, R Norman, L Holden, KA Read, JM Dondelinger, F Carson, G Merson, L Lee, J Plotkin, D Sigfrid, L Halpin, S Jackson, C Gamble, C Horby, PW Nguyen-Van-Tam, JS Ho, A Russell, CD Dunning, J Openshaw, PJ Baillie, JK Semple, MG ISARIC4C investigators |
| author_sort | Docherty, AB |
| collection | OXFORD |
| description | <p><strong>OBJECTIVE:</strong> To characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study, and to explore risk factors associated with mortality in hospital.</p>
<p><strong>DESIGN:</strong> Prospective observational cohort study with rapid data gathering and near real time analysis.</p>
<p><strong>SETTING:</strong> 208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020. A case report form developed by ISARIC and WHO was used to collect clinical data. A minimal follow-up time of two weeks (to 3 May 2020) allowed most patients to complete their hospital admission. PARTICIPANTS:20 133 hospital inpatients with covid-19.</p>
<p><strong>MAIN OUTCOME MEASURES:</strong> Admission to critical care (high dependency unit or intensive care unit) and mortality in hospital.</p>
<p><strong>RESULTS:</strong> The median age of patients admitted to hospital with covid-19, or with a diagnosis of covid-19 made in hospital, was 73 years (interquartile range 58-82, range 0-104). More men were admitted than women (men 60%, n=12 068; women 40%, n=8065). The median duration of symptoms before admission was 4 days (interquartile range 1-8). The commonest comorbidities were chronic cardiac disease (31%, 5469/17 702), uncomplicated diabetes (21%, 3650/17 599), non-asthmatic chronic pulmonary disease (18%, 3128/17 634), and chronic kidney disease (16%, 2830/17 506); 23% (4161/18 525) had no reported major comorbidity. Overall, 41% (8199/20 133) of patients were discharged alive, 26% (5165/20 133) died, and 34% (6769/20 133) continued to receive care at the reporting date. 17% (3001/18 183) required admission to high dependency or intensive care units; of these, 28% (826/3001) were discharged alive, 32% (958/3001) died, and 41% (1217/3001) continued to receive care at the reporting date. Of those receiving mechanical ventilation, 17% (276/1658) were discharged alive, 37% (618/1658) died, and 46% (764/1658) remained in hospital. Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital.</p>
<p><strong>CONCLUSIONS:</strong> ISARIC WHO CCP-UK is a large prospective cohort study of patients in hospital with covid-19. The study continues to enrol at the time of this report. In study participants, mortality was high, independent risk factors were increasing age, male sex, and chronic comorbidity, including obesity. This study has shown the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.</p>
<p><strong>STUDY REGISTRATION:</strong> ISRCTN66726260.</p> |
| first_indexed | 2024-03-06T18:34:49Z |
| format | Journal article |
| id | oxford-uuid:0ad7c50a-a3b0-47db-ba31-cfa9a2bc7b1b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T18:34:49Z |
| publishDate | 2020 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:0ad7c50a-a3b0-47db-ba31-cfa9a2bc7b1b2022-03-26T09:26:20ZFeatures of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0ad7c50a-a3b0-47db-ba31-cfa9a2bc7b1bEnglishSymplectic ElementsBMJ Publishing Group2020Docherty, ABHarrison, EWGreen, CAHardwick, HEPius, RNorman, LHolden, KARead, JMDondelinger, FCarson, GMerson, LLee, JPlotkin, DSigfrid, LHalpin, SJackson, CGamble, CHorby, PWNguyen-Van-Tam, JSHo, ARussell, CDDunning, JOpenshaw, PJBaillie, JKSemple, MGISARIC4C investigators<p><strong>OBJECTIVE:</strong> To characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study, and to explore risk factors associated with mortality in hospital.</p> <p><strong>DESIGN:</strong> Prospective observational cohort study with rapid data gathering and near real time analysis.</p> <p><strong>SETTING:</strong> 208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020. A case report form developed by ISARIC and WHO was used to collect clinical data. A minimal follow-up time of two weeks (to 3 May 2020) allowed most patients to complete their hospital admission. PARTICIPANTS:20 133 hospital inpatients with covid-19.</p> <p><strong>MAIN OUTCOME MEASURES:</strong> Admission to critical care (high dependency unit or intensive care unit) and mortality in hospital.</p> <p><strong>RESULTS:</strong> The median age of patients admitted to hospital with covid-19, or with a diagnosis of covid-19 made in hospital, was 73 years (interquartile range 58-82, range 0-104). More men were admitted than women (men 60%, n=12 068; women 40%, n=8065). The median duration of symptoms before admission was 4 days (interquartile range 1-8). The commonest comorbidities were chronic cardiac disease (31%, 5469/17 702), uncomplicated diabetes (21%, 3650/17 599), non-asthmatic chronic pulmonary disease (18%, 3128/17 634), and chronic kidney disease (16%, 2830/17 506); 23% (4161/18 525) had no reported major comorbidity. Overall, 41% (8199/20 133) of patients were discharged alive, 26% (5165/20 133) died, and 34% (6769/20 133) continued to receive care at the reporting date. 17% (3001/18 183) required admission to high dependency or intensive care units; of these, 28% (826/3001) were discharged alive, 32% (958/3001) died, and 41% (1217/3001) continued to receive care at the reporting date. Of those receiving mechanical ventilation, 17% (276/1658) were discharged alive, 37% (618/1658) died, and 46% (764/1658) remained in hospital. Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital.</p> <p><strong>CONCLUSIONS:</strong> ISARIC WHO CCP-UK is a large prospective cohort study of patients in hospital with covid-19. The study continues to enrol at the time of this report. In study participants, mortality was high, independent risk factors were increasing age, male sex, and chronic comorbidity, including obesity. This study has shown the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.</p> <p><strong>STUDY REGISTRATION:</strong> ISRCTN66726260.</p> |
| spellingShingle | Docherty, AB Harrison, EW Green, CA Hardwick, HE Pius, R Norman, L Holden, KA Read, JM Dondelinger, F Carson, G Merson, L Lee, J Plotkin, D Sigfrid, L Halpin, S Jackson, C Gamble, C Horby, PW Nguyen-Van-Tam, JS Ho, A Russell, CD Dunning, J Openshaw, PJ Baillie, JK Semple, MG ISARIC4C investigators Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study |
| title | Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study |
| title_full | Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study |
| title_fullStr | Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study |
| title_full_unstemmed | Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study |
| title_short | Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study |
| title_sort | features of 20 133 uk patients in hospital with covid 19 using the isaric who clinical characterisation protocol prospective observational cohort study |
| work_keys_str_mv | AT dochertyab featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT harrisonew featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT greenca featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT hardwickhe featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT piusr featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT normanl featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT holdenka featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT readjm featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT dondelingerf featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT carsong featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT mersonl featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT leej featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT plotkind featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT sigfridl featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT halpins featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT jacksonc featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT gamblec featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT horbypw featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT nguyenvantamjs featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT hoa featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT russellcd featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT dunningj featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT openshawpj featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT bailliejk featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT semplemg featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy AT isaric4cinvestigators featuresof20133ukpatientsinhospitalwithcovid19usingtheisaricwhoclinicalcharacterisationprotocolprospectiveobservationalcohortstudy |