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Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study
OBJECTIVES: To examine the temporal patterns of patient characteristics, treatments used and outcomes associated with COVID-19 in patients who were hospitalised for the disease between January and 15 November 2020. DESIGN: Observational cohort study. SETTING: COVID-19 subset of the Optum deidentifie...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886119/ https://www.ncbi.nlm.nih.gov/pubmed/35228287 http://dx.doi.org/10.1136/bmjopen-2021-055137 |
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author | Page, John H Londhe, Ajit A Brooks, Corinne Zhang, Jie Sprafka, J Michael Bennett, Corina Braunlin, Megan Brown, Carolyn A Charuworn, Prista Cheng, Alvan Gill, Karminder He, Fang Ma, Junjie Petersen, Jeffrey Ayodele, Olulade Bao, Ying Carlson, Katherine B Chang, Shun-Chiao Devercelli, Giovanna Jonsson-Funk, Michele Jiang, Jenny Keenan, Hillary A Ren, Kaili Roehl, Kimberly A Sanders, Lynn Wang, Luyang Wei, Zhongyuan Xia, Qian Yu, Peter Zhou, Linyun Zhu, Julia Gondek, Kathleen Critchlow, Cathy W Bradbury, Brian D |
author_facet | Page, John H Londhe, Ajit A Brooks, Corinne Zhang, Jie Sprafka, J Michael Bennett, Corina Braunlin, Megan Brown, Carolyn A Charuworn, Prista Cheng, Alvan Gill, Karminder He, Fang Ma, Junjie Petersen, Jeffrey Ayodele, Olulade Bao, Ying Carlson, Katherine B Chang, Shun-Chiao Devercelli, Giovanna Jonsson-Funk, Michele Jiang, Jenny Keenan, Hillary A Ren, Kaili Roehl, Kimberly A Sanders, Lynn Wang, Luyang Wei, Zhongyuan Xia, Qian Yu, Peter Zhou, Linyun Zhu, Julia Gondek, Kathleen Critchlow, Cathy W Bradbury, Brian D |
author_sort | Page, John H |
collection | PubMed |
description | OBJECTIVES: To examine the temporal patterns of patient characteristics, treatments used and outcomes associated with COVID-19 in patients who were hospitalised for the disease between January and 15 November 2020. DESIGN: Observational cohort study. SETTING: COVID-19 subset of the Optum deidentified electronic health records, including more than 1.8 million patients from across the USA. PARTICIPANTS: There were 51 510 hospitalised patients who met the COVID-19 definition, with 37 617 in the laboratory positive cohort and 13 893 in the clinical cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: Incident acute clinical outcomes, including in-hospital all-cause mortality. RESULTS: Respectively, 48% and 49% of the laboratory positive and clinical cohorts were women. The 50– 65 age group was the median age group for both cohorts. The use of antivirals and dexamethasone increased over time, fivefold and twofold, respectively, while the use of hydroxychloroquine declined by 98%. Among adult patients in the laboratory positive cohort, absolute age/sex standardised incidence proportion for in-hospital death changed by −0.036 per month (95% CI −0.042 to –0.031) from March to June 2020, but remained fairly flat from June to November, 2020 (0.001 (95% CI −0.001 to 0.003), 17.5% (660 deaths /3986 persons) in March and 10.2% (580/5137) in October); in the clinical cohort, the corresponding changes were −0.024 (95% CI −0.032 to –0.015) and 0.011 (95% CI 0.007 0.014), respectively (14.8% (175/1252) in March, 15.3% (189/1203) in October). Declines in the cumulative incidence of most acute clinical outcomes were observed in the laboratory positive cohort, but not for the clinical cohort. CONCLUSION: The incidence of adverse clinical outcomes remains high among COVID-19 patients with clinical diagnosis only. Patients with COVID-19 entering the hospital are at elevated risk of adverse outcomes. |
format | Online Article Text |
id | pubmed-8886119 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-88861192022-03-01 Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study Page, John H Londhe, Ajit A Brooks, Corinne Zhang, Jie Sprafka, J Michael Bennett, Corina Braunlin, Megan Brown, Carolyn A Charuworn, Prista Cheng, Alvan Gill, Karminder He, Fang Ma, Junjie Petersen, Jeffrey Ayodele, Olulade Bao, Ying Carlson, Katherine B Chang, Shun-Chiao Devercelli, Giovanna Jonsson-Funk, Michele Jiang, Jenny Keenan, Hillary A Ren, Kaili Roehl, Kimberly A Sanders, Lynn Wang, Luyang Wei, Zhongyuan Xia, Qian Yu, Peter Zhou, Linyun Zhu, Julia Gondek, Kathleen Critchlow, Cathy W Bradbury, Brian D BMJ Open Epidemiology OBJECTIVES: To examine the temporal patterns of patient characteristics, treatments used and outcomes associated with COVID-19 in patients who were hospitalised for the disease between January and 15 November 2020. DESIGN: Observational cohort study. SETTING: COVID-19 subset of the Optum deidentified electronic health records, including more than 1.8 million patients from across the USA. PARTICIPANTS: There were 51 510 hospitalised patients who met the COVID-19 definition, with 37 617 in the laboratory positive cohort and 13 893 in the clinical cohort. PRIMARY AND SECONDARY OUTCOME MEASURES: Incident acute clinical outcomes, including in-hospital all-cause mortality. RESULTS: Respectively, 48% and 49% of the laboratory positive and clinical cohorts were women. The 50– 65 age group was the median age group for both cohorts. The use of antivirals and dexamethasone increased over time, fivefold and twofold, respectively, while the use of hydroxychloroquine declined by 98%. Among adult patients in the laboratory positive cohort, absolute age/sex standardised incidence proportion for in-hospital death changed by −0.036 per month (95% CI −0.042 to –0.031) from March to June 2020, but remained fairly flat from June to November, 2020 (0.001 (95% CI −0.001 to 0.003), 17.5% (660 deaths /3986 persons) in March and 10.2% (580/5137) in October); in the clinical cohort, the corresponding changes were −0.024 (95% CI −0.032 to –0.015) and 0.011 (95% CI 0.007 0.014), respectively (14.8% (175/1252) in March, 15.3% (189/1203) in October). Declines in the cumulative incidence of most acute clinical outcomes were observed in the laboratory positive cohort, but not for the clinical cohort. CONCLUSION: The incidence of adverse clinical outcomes remains high among COVID-19 patients with clinical diagnosis only. Patients with COVID-19 entering the hospital are at elevated risk of adverse outcomes. BMJ Publishing Group 2022-02-28 /pmc/articles/PMC8886119/ /pubmed/35228287 http://dx.doi.org/10.1136/bmjopen-2021-055137 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Epidemiology Page, John H Londhe, Ajit A Brooks, Corinne Zhang, Jie Sprafka, J Michael Bennett, Corina Braunlin, Megan Brown, Carolyn A Charuworn, Prista Cheng, Alvan Gill, Karminder He, Fang Ma, Junjie Petersen, Jeffrey Ayodele, Olulade Bao, Ying Carlson, Katherine B Chang, Shun-Chiao Devercelli, Giovanna Jonsson-Funk, Michele Jiang, Jenny Keenan, Hillary A Ren, Kaili Roehl, Kimberly A Sanders, Lynn Wang, Luyang Wei, Zhongyuan Xia, Qian Yu, Peter Zhou, Linyun Zhu, Julia Gondek, Kathleen Critchlow, Cathy W Bradbury, Brian D Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study |
title | Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study |
title_full | Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study |
title_fullStr | Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study |
title_full_unstemmed | Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study |
title_short | Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study |
title_sort | trends in characteristics and outcomes among us adults hospitalised with covid-19 throughout 2020: an observational cohort study |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8886119/ https://www.ncbi.nlm.nih.gov/pubmed/35228287 http://dx.doi.org/10.1136/bmjopen-2021-055137 |
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