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Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2
OBJECTIVE: To assess changes in international mortality rates and laboratory recovery rates during hospitalisation for patients hospitalised with SARS-CoV-2 between the first wave (1 March to 30 June 2020) and the second wave (1 July 2020 to 31 January 2021) of the COVID-19 pandemic. DESIGN, SETTING...
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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/PMC9226470/ https://www.ncbi.nlm.nih.gov/pubmed/35738646 http://dx.doi.org/10.1136/bmjopen-2021-057725 |
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author | Hong, Chuan Zhang, Harrison G L'Yi, Sehi Weber, Griffin Avillach, Paul Tan, Bryce W Q Gutiérrez-Sacristán, Alba Bonzel, Clara-Lea Palmer, Nathan P Malovini, Alberto Tibollo, Valentina Luo, Yuan Hutch, Meghan R Liu, Molei Bourgeois, Florence Bellazzi, Riccardo Chiovato, Luca Sanz Vidorreta, Fernando J Le, Trang T Wang, Xuan Yuan, William Neuraz, Antoine Benoit, Vincent Moal, Bertrand Morris, Michele Hanauer, David A Maidlow, Sarah Wagholikar, Kavishwar Murphy, Shawn Estiri, Hossein Makoudjou, Adeline Tippmann, Patric Klann, Jeffery Follett, Robert W Gehlenborg, Nils Omenn, Gilbert S Xia, Zongqi Dagliati, Arianna Visweswaran, Shyam Patel, Lav P Mowery, Danielle L Schriver, Emily R Samayamuthu, Malarkodi Jebathilagam Kavuluru, Ramakanth Lozano-Zahonero, Sara Zöller, Daniela Tan, Amelia L M Tan, Byorn W L Ngiam, Kee Yuan Holmes, John H Schubert, Petra Cho, Kelly Ho, Yuk-Lam Beaulieu-Jones, Brett K. Pedrera-Jiménez, Miguel García-Barrio, Noelia Serrano-Balazote, Pablo Kohane, Isaac South, Andrew Brat, Gabriel A Cai, Tianxi |
author_facet | Hong, Chuan Zhang, Harrison G L'Yi, Sehi Weber, Griffin Avillach, Paul Tan, Bryce W Q Gutiérrez-Sacristán, Alba Bonzel, Clara-Lea Palmer, Nathan P Malovini, Alberto Tibollo, Valentina Luo, Yuan Hutch, Meghan R Liu, Molei Bourgeois, Florence Bellazzi, Riccardo Chiovato, Luca Sanz Vidorreta, Fernando J Le, Trang T Wang, Xuan Yuan, William Neuraz, Antoine Benoit, Vincent Moal, Bertrand Morris, Michele Hanauer, David A Maidlow, Sarah Wagholikar, Kavishwar Murphy, Shawn Estiri, Hossein Makoudjou, Adeline Tippmann, Patric Klann, Jeffery Follett, Robert W Gehlenborg, Nils Omenn, Gilbert S Xia, Zongqi Dagliati, Arianna Visweswaran, Shyam Patel, Lav P Mowery, Danielle L Schriver, Emily R Samayamuthu, Malarkodi Jebathilagam Kavuluru, Ramakanth Lozano-Zahonero, Sara Zöller, Daniela Tan, Amelia L M Tan, Byorn W L Ngiam, Kee Yuan Holmes, John H Schubert, Petra Cho, Kelly Ho, Yuk-Lam Beaulieu-Jones, Brett K. Pedrera-Jiménez, Miguel García-Barrio, Noelia Serrano-Balazote, Pablo Kohane, Isaac South, Andrew Brat, Gabriel A Cai, Tianxi |
author_sort | Hong, Chuan |
collection | PubMed |
description | OBJECTIVE: To assess changes in international mortality rates and laboratory recovery rates during hospitalisation for patients hospitalised with SARS-CoV-2 between the first wave (1 March to 30 June 2020) and the second wave (1 July 2020 to 31 January 2021) of the COVID-19 pandemic. DESIGN, SETTING AND PARTICIPANTS: This is a retrospective cohort study of 83 178 hospitalised patients admitted between 7 days before or 14 days after PCR-confirmed SARS-CoV-2 infection within the Consortium for Clinical Characterization of COVID-19 by Electronic Health Record, an international multihealthcare system collaborative of 288 hospitals in the USA and Europe. The laboratory recovery rates and mortality rates over time were compared between the two waves of the pandemic. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was all-cause mortality rate within 28 days after hospitalisation stratified by predicted low, medium and high mortality risk at baseline. The secondary outcome was the average rate of change in laboratory values during the first week of hospitalisation. RESULTS: Baseline Charlson Comorbidity Index and laboratory values at admission were not significantly different between the first and second waves. The improvement in laboratory values over time was faster in the second wave compared with the first. The average C reactive protein rate of change was –4.72 mg/dL vs –4.14 mg/dL per day (p=0.05). The mortality rates within each risk category significantly decreased over time, with the most substantial decrease in the high-risk group (47.1% in March–April 2020 vs 30.8% in November 2020 to January 2021, p<0.001) and a moderate decrease in the intermediate-risk group (21.5% in March–April 2020 vs 14.3% in November 2020 to January 2021, p<0.001). CONCLUSIONS: Admission profiles of patients hospitalised with SARS-CoV-2 infection did not differ greatly between the first and second waves of the pandemic, but there were notable differences in laboratory improvement rates during hospitalisation. Mortality risks among patients with similar risk profiles decreased over the course of the pandemic. The improvement in laboratory values and mortality risk was consistent across multiple countries. |
format | Online Article Text |
id | pubmed-9226470 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-92264702022-06-28 Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 Hong, Chuan Zhang, Harrison G L'Yi, Sehi Weber, Griffin Avillach, Paul Tan, Bryce W Q Gutiérrez-Sacristán, Alba Bonzel, Clara-Lea Palmer, Nathan P Malovini, Alberto Tibollo, Valentina Luo, Yuan Hutch, Meghan R Liu, Molei Bourgeois, Florence Bellazzi, Riccardo Chiovato, Luca Sanz Vidorreta, Fernando J Le, Trang T Wang, Xuan Yuan, William Neuraz, Antoine Benoit, Vincent Moal, Bertrand Morris, Michele Hanauer, David A Maidlow, Sarah Wagholikar, Kavishwar Murphy, Shawn Estiri, Hossein Makoudjou, Adeline Tippmann, Patric Klann, Jeffery Follett, Robert W Gehlenborg, Nils Omenn, Gilbert S Xia, Zongqi Dagliati, Arianna Visweswaran, Shyam Patel, Lav P Mowery, Danielle L Schriver, Emily R Samayamuthu, Malarkodi Jebathilagam Kavuluru, Ramakanth Lozano-Zahonero, Sara Zöller, Daniela Tan, Amelia L M Tan, Byorn W L Ngiam, Kee Yuan Holmes, John H Schubert, Petra Cho, Kelly Ho, Yuk-Lam Beaulieu-Jones, Brett K. Pedrera-Jiménez, Miguel García-Barrio, Noelia Serrano-Balazote, Pablo Kohane, Isaac South, Andrew Brat, Gabriel A Cai, Tianxi BMJ Open Epidemiology OBJECTIVE: To assess changes in international mortality rates and laboratory recovery rates during hospitalisation for patients hospitalised with SARS-CoV-2 between the first wave (1 March to 30 June 2020) and the second wave (1 July 2020 to 31 January 2021) of the COVID-19 pandemic. DESIGN, SETTING AND PARTICIPANTS: This is a retrospective cohort study of 83 178 hospitalised patients admitted between 7 days before or 14 days after PCR-confirmed SARS-CoV-2 infection within the Consortium for Clinical Characterization of COVID-19 by Electronic Health Record, an international multihealthcare system collaborative of 288 hospitals in the USA and Europe. The laboratory recovery rates and mortality rates over time were compared between the two waves of the pandemic. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was all-cause mortality rate within 28 days after hospitalisation stratified by predicted low, medium and high mortality risk at baseline. The secondary outcome was the average rate of change in laboratory values during the first week of hospitalisation. RESULTS: Baseline Charlson Comorbidity Index and laboratory values at admission were not significantly different between the first and second waves. The improvement in laboratory values over time was faster in the second wave compared with the first. The average C reactive protein rate of change was –4.72 mg/dL vs –4.14 mg/dL per day (p=0.05). The mortality rates within each risk category significantly decreased over time, with the most substantial decrease in the high-risk group (47.1% in March–April 2020 vs 30.8% in November 2020 to January 2021, p<0.001) and a moderate decrease in the intermediate-risk group (21.5% in March–April 2020 vs 14.3% in November 2020 to January 2021, p<0.001). CONCLUSIONS: Admission profiles of patients hospitalised with SARS-CoV-2 infection did not differ greatly between the first and second waves of the pandemic, but there were notable differences in laboratory improvement rates during hospitalisation. Mortality risks among patients with similar risk profiles decreased over the course of the pandemic. The improvement in laboratory values and mortality risk was consistent across multiple countries. BMJ Publishing Group 2022-06-22 /pmc/articles/PMC9226470/ /pubmed/35738646 http://dx.doi.org/10.1136/bmjopen-2021-057725 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 Hong, Chuan Zhang, Harrison G L'Yi, Sehi Weber, Griffin Avillach, Paul Tan, Bryce W Q Gutiérrez-Sacristán, Alba Bonzel, Clara-Lea Palmer, Nathan P Malovini, Alberto Tibollo, Valentina Luo, Yuan Hutch, Meghan R Liu, Molei Bourgeois, Florence Bellazzi, Riccardo Chiovato, Luca Sanz Vidorreta, Fernando J Le, Trang T Wang, Xuan Yuan, William Neuraz, Antoine Benoit, Vincent Moal, Bertrand Morris, Michele Hanauer, David A Maidlow, Sarah Wagholikar, Kavishwar Murphy, Shawn Estiri, Hossein Makoudjou, Adeline Tippmann, Patric Klann, Jeffery Follett, Robert W Gehlenborg, Nils Omenn, Gilbert S Xia, Zongqi Dagliati, Arianna Visweswaran, Shyam Patel, Lav P Mowery, Danielle L Schriver, Emily R Samayamuthu, Malarkodi Jebathilagam Kavuluru, Ramakanth Lozano-Zahonero, Sara Zöller, Daniela Tan, Amelia L M Tan, Byorn W L Ngiam, Kee Yuan Holmes, John H Schubert, Petra Cho, Kelly Ho, Yuk-Lam Beaulieu-Jones, Brett K. Pedrera-Jiménez, Miguel García-Barrio, Noelia Serrano-Balazote, Pablo Kohane, Isaac South, Andrew Brat, Gabriel A Cai, Tianxi Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 |
title | Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 |
title_full | Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 |
title_fullStr | Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 |
title_full_unstemmed | Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 |
title_short | Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2 |
title_sort | changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with sars-cov-2 |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226470/ https://www.ncbi.nlm.nih.gov/pubmed/35738646 http://dx.doi.org/10.1136/bmjopen-2021-057725 |
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