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Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study
OBJECTIVES: In Germany the coronavirus disease 2019 (COVID-19) pandemic situation is unique among large European countries in that incidence and case fatality rate are distinctly lower. We describe the clinical course and examine factors associated with outcomes among patients hospitalized with COVI...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434317/ https://www.ncbi.nlm.nih.gov/pubmed/32822883 http://dx.doi.org/10.1016/j.cmi.2020.08.011 |
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author | Nachtigall, Irit Lenga, Pavlina Jóźwiak, Katarzyna Thürmann, Petra Meier-Hellmann, Andreas Kuhlen, Ralf Brederlau, Joerg Bauer, Torsten Tebbenjohanns, Juergen Schwegmann, Karin Hauptmann, Michael Dengler, Julius |
author_facet | Nachtigall, Irit Lenga, Pavlina Jóźwiak, Katarzyna Thürmann, Petra Meier-Hellmann, Andreas Kuhlen, Ralf Brederlau, Joerg Bauer, Torsten Tebbenjohanns, Juergen Schwegmann, Karin Hauptmann, Michael Dengler, Julius |
author_sort | Nachtigall, Irit |
collection | PubMed |
description | OBJECTIVES: In Germany the coronavirus disease 2019 (COVID-19) pandemic situation is unique among large European countries in that incidence and case fatality rate are distinctly lower. We describe the clinical course and examine factors associated with outcomes among patients hospitalized with COVID-19 in Germany. METHODS: In this retrospective cohort study we included patients with COVID-19 admitted to a national network of German hospitals between February 12 and June 12, 2020. We examined demographic characteristics, comorbidities and clinical outcomes. RESULTS: We included 1904 patients with a median age of 73 years, 48.5% (924/1904) of whom were female. The mortality rate was 17% (317/1835; 95% confidence interval (95%CI) 16–19), the rate of admission to the intensive care unit (ICU) was 21% (399/1860; 95%CI 20–23), and the rate of invasive mechanical ventilation was 14% (250/1850: 95%CI 12–15). The most prominent risk factors for death were male sex (hazard ratio (HR) 1.45; 95%CI 1.15–1.83), pre-existing lung disease (HR 1.61; 95%CI 1.20–2.16), and increased patient age (HR 4.11 (95%CI 2.57–6.58) for age >79 years versus <60 years). Among patients admitted to the ICU, the mortality rate was 29% (109/374; 95%CI 25–34) and higher in ventilated (33% [77/235; 95%CI 27–39]) than in non-ventilated ICU patients (23%, 32/139; 95%CI 16–30; p < 0.05). CONCLUSIONS: In this nationwide series of patients hospitalized with COVID-19 in Germany, in-hospital and ICU mortality rates were substantial. The most prominent risk factors for death were male sex, pre-existing lung disease, and greater patient age. |
format | Online Article Text |
id | pubmed-7434317 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74343172020-08-19 Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study Nachtigall, Irit Lenga, Pavlina Jóźwiak, Katarzyna Thürmann, Petra Meier-Hellmann, Andreas Kuhlen, Ralf Brederlau, Joerg Bauer, Torsten Tebbenjohanns, Juergen Schwegmann, Karin Hauptmann, Michael Dengler, Julius Clin Microbiol Infect Original Article OBJECTIVES: In Germany the coronavirus disease 2019 (COVID-19) pandemic situation is unique among large European countries in that incidence and case fatality rate are distinctly lower. We describe the clinical course and examine factors associated with outcomes among patients hospitalized with COVID-19 in Germany. METHODS: In this retrospective cohort study we included patients with COVID-19 admitted to a national network of German hospitals between February 12 and June 12, 2020. We examined demographic characteristics, comorbidities and clinical outcomes. RESULTS: We included 1904 patients with a median age of 73 years, 48.5% (924/1904) of whom were female. The mortality rate was 17% (317/1835; 95% confidence interval (95%CI) 16–19), the rate of admission to the intensive care unit (ICU) was 21% (399/1860; 95%CI 20–23), and the rate of invasive mechanical ventilation was 14% (250/1850: 95%CI 12–15). The most prominent risk factors for death were male sex (hazard ratio (HR) 1.45; 95%CI 1.15–1.83), pre-existing lung disease (HR 1.61; 95%CI 1.20–2.16), and increased patient age (HR 4.11 (95%CI 2.57–6.58) for age >79 years versus <60 years). Among patients admitted to the ICU, the mortality rate was 29% (109/374; 95%CI 25–34) and higher in ventilated (33% [77/235; 95%CI 27–39]) than in non-ventilated ICU patients (23%, 32/139; 95%CI 16–30; p < 0.05). CONCLUSIONS: In this nationwide series of patients hospitalized with COVID-19 in Germany, in-hospital and ICU mortality rates were substantial. The most prominent risk factors for death were male sex, pre-existing lung disease, and greater patient age. The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. 2020-12 2020-08-18 /pmc/articles/PMC7434317/ /pubmed/32822883 http://dx.doi.org/10.1016/j.cmi.2020.08.011 Text en © 2020 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article Nachtigall, Irit Lenga, Pavlina Jóźwiak, Katarzyna Thürmann, Petra Meier-Hellmann, Andreas Kuhlen, Ralf Brederlau, Joerg Bauer, Torsten Tebbenjohanns, Juergen Schwegmann, Karin Hauptmann, Michael Dengler, Julius Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study |
title | Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study |
title_full | Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study |
title_fullStr | Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study |
title_full_unstemmed | Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study |
title_short | Clinical course and factors associated with outcomes among 1904 patients hospitalized with COVID-19 in Germany: an observational study |
title_sort | clinical course and factors associated with outcomes among 1904 patients hospitalized with covid-19 in germany: an observational study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7434317/ https://www.ncbi.nlm.nih.gov/pubmed/32822883 http://dx.doi.org/10.1016/j.cmi.2020.08.011 |
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