| Title: |
Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK |
| Authors: |
Docherty, AB; Mulholland, RH; Lone, NI; Cheyne, CP; De Angelis, D; Diaz-Ordaz, K; Donegan, C; Drake, TM; Dunning, J; Funk, S; García-Fiñana, M; Girvan, M; Hardwick, HE; Harrison, J; Ho, A; Hughes, DM; Keogh, RH; Kirwan, PD; Leeming, G; Van-Tam, JSN; Pius, R; Russell, CD; Spencer, RG; Tom, BDM; Turtle, L; Openshaw, PJM; Baillie, JK; Harrison, EM; Semple, MG; Carson, G; Alex, B; Bach, B; Barclay, WS; Bogaert, D; Chand, M; Cooke, GS; da Silva Filipe, A; Fletcher, T; Green, CA; Hiscox, JA; Ho, AYW; Horby, PW; Ijaz, S; Khoo, S; Klenerman, P; Law, A; Lim, WS; Mentzer, AJ; Merson, L; Meynert, AM; Noursadeghi, M; Moore, SC; Palmarini, M; Paxton, WA; Pollakis, G; Price, N; Rambaut, A; Robertson, DL; Sancho-Shimizu, V; Scott, JT; de Silva, T; Sigfrid, L; Solomon, T; Sriskandan, S; Stuart, D; Summers, C; Tedder, RS; Thomson, EC; Thompson, AAR; Thwaites, RS; Turtle, LCW; Gupta, RK; Palmieri, C; Zambon, M; Hardwick, H; Donohue, C; Lyons, R; Griffiths, F; Oosthuyzen, W; Norman, L; Fairfield, CJ; Knight, SR; Mclean, KA; Murphy, D; Shaw, CA; Dalton, J; Saviciute, E; Roberts, S; Marsh, L; Connor, M; Halpin, S; Jackson, C; Gamble, C; Wham, M; Clohisey, S; Hendry, R; Scott-Brown, J; Greenhalf, W; Shaw, V; McDonald, SE; Keating, S; Ahmed, KA; Armstrong, JA; Ashworth, M; Asiimwe, IG; Bakshi, S; Barlow, SL; Booth, L; Brennan, B; Bullock, K; Catterall, BWA; Clark, JJ; Clarke, EA; Cole, S; Cooper, L; Cox, H; Davis, C; Dincarslan, O; Dunn, C; Dyer, P; Elliott, A; Evans, A; Finch, L; Fisher, LWS; Foster, T; Garcia-Dorival, I; Gunning, P; Hartley, C; Jensen, RL; Jones, CB; Jones, TR; Khandaker, S; King, K; Kiy, RT; Koukorava, C; Lake, A; Lant, S; Latawiec, D; Lavelle-Langham, L; Lefteri, D; Lett, L; Livoti, LA; Mancini, M; McDonald, S; McEvoy, L; McLauchlan, J; Metelmann, S; Miah, NS; Middleton, J; Mitchell, J; Moore, E; Murphy, EG; Penrice-Randal, R; Pilgrim, J; Prince, T; Reynolds, W; Ridley, PM; Sales, D; Shaw, VE; Shears, RK; Small, B; Subramaniam, KS; Szemiel, A; Taggart, A; Tanianis-Hughes, J; Thomas, J; Trochu, E; van Tonder, L; Wilcock, E; Zhang, JE; Flaherty, L; Maziere, N; Cass, E; Carracedo, AD; Carlucci, N; Holmes, A; Massey, H; Murphy, L; Wrobel, N; McCafferty, S; Morrice, K; MacLean, A; Adeniji, K; Agranoff, D; Agwuh, K; Ail, D; Aldera, EL; Alegria, A; Angus, B; Ashish, A; Atkinson, D; Bari, S; Barlow, G; Barnass, S; Barrett, N; Bassford, C; Basude, S; Baxter, D; Beadsworth, M; Bernatoniene, J; Berridge, J; Best, N; Bothma, P; Chadwick, D; Brittain-Long, R; Bulteel, N; Burden, T; Burtenshaw, A; Caruth, V; Chambler, D; Chee, N; Child, J; Chukkambotla, S; Clark, T; Collini, P; Cosgrove, C; Cupitt, J; Cutino-Moguel, M-T; Dark, P; Dawson, C; Dervisevic, S; Donnison, P; Douthwaite, S; DuRand, I; Dushianthan, A; Dyer, T; Evans, C; Eziefula, C; Fegan, C; Finn, A; Fullerton, D; Garg, S; Garg, A; Gkrania-Klotsas, E; Godden, J; Goldsmith, A; Graham, C; Hardy, E; Hartshorn, S; Harvey, D; Havalda, P; Hawcutt, DB; Hobrok, M; Hodgson, L; Hormis, A; Jacobs, M; Jain, S; Jennings, P; Kaliappan, A; Kasipandian, V; Kegg, S; Kelsey, M; Kendall, J; Kerrison, C; Kerslake, I; Koch, O; Koduri, G; Koshy, G; Laha, S; Laird, S; Larkin, S; Leiner, T; Lillie, P; Limb, J; Linnett, V; Little, J; Lyttle, M; MacMahon, M; MacNaughton, E; Mankregod, R; Masson, H; Matovu, E; McCullough, K; McEwen, R; Meda, M; Mills, G; Minton, J; Mirfenderesky, M; Mohandas, K; Mok, Q; Moon, J; Morgan, P; Morris, C; Mortimore, K; Moses, S; Mpenge, M; Mulla, R; Murphy, M; Nagel, M; Nagarajan, T; Nelson, M; O'Shea, MK; Otahal, I; Ostermann, M; Pais, M; Panchatsharam, S; Papakonstantinou, D; Paraiso, H; Patel, B; Pattison, N; Pepperell, J; Peters, M; Phull, M; Pintus, S; Pooni, JS; Post, F; Price, D; Prout, R; Rae, N; Reschreiter, H; Reynolds, T; Richardson, N; Roberts, M; Roberts, D; Rose, A; Rousseau, G; Ryan, B; Saluja, T; Shah, A; Shanmuga, P; Sharma, A; Shawcross, A; Sizer, J; Shankar-Hari, M; Smith, R; Snelson, C; Spittle, N; Staines, N; Stambach, T; Stewart, R; Subudhi, P; Szakmany, T; Tatham, K; Thompson, C; Thompson, R; Tridente, A; Tupper-Carey, D; Twagira, M; Ustianowski, A; Vallotton, N; Vincent-Smith, L; Visuvanathan, S; Vuylsteke, A; Waddy, S; Wake, R; Walden, A; Welters, I; Whitehouse, T; Whittaker, P; Whittington, A; Papineni, P; Wijesinghe, M; Williams, M; Wilson, L; Sarah, S; Winchester, S; Wiselka, M; Wolverson, A; Wooton, DG; Workman, A; Yates, B; Young, P |
| Publisher Information: |
Elsevier |
| Publication Year: |
2021 |
| Collection: |
White Rose Research Online (Universities of Leeds, Sheffield & York) |
| Description: |
Background Mortality rates in hospitalised patients with COVID-19 in the UK appeared to decline during the first wave of the pandemic. We aimed to quantify potential drivers of this change and identify groups of patients who remain at high risk of dying in hospital. Methods In this multicentre prospective observational cohort study, the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK recruited a prospective cohort of patients with COVID-19 admitted to 247 acute hospitals in England, Scotland, and Wales during the first wave of the pandemic (between March 9 and Aug 2, 2020). We included all patients aged 18 years and older with clinical signs and symptoms of COVID-19 or confirmed COVID-19 (by RT-PCR test) from assumed community-acquired infection. We did a three-way decomposition mediation analysis using natural effects models to explore associations between week of admission and in-hospital mortality, adjusting for confounders (demographics, comorbidities, and severity of illness) and quantifying potential mediators (level of respiratory support and steroid treatment). The primary outcome was weekly in-hospital mortality at 28 days, defined as the proportion of patients who had died within 28 days of admission of all patients admitted in the observed week, and it was assessed in all patients with an outcome. This study is registered with the ISRCTN Registry, ISRCTN66726260. Findings Between March 9, and Aug 2, 2020, we recruited 80 713 patients, of whom 63 972 were eligible and included in the study. Unadjusted weekly in-hospital mortality declined from 32·3% (95% CI 31·8–32·7) in March 9 to April 26, 2020, to 16·4% (15·0–17·8) in June 15 to Aug 2, 2020. Reductions in mortality were observed in all age groups, in all ethnic groups, for both sexes, and in patients with and without comorbidities. After adjustment, there was a 32% reduction in the risk of mortality per 7-week period (odds ratio [OR] 0·68 [95% CI 0·65–0·71]). The higher proportions ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
2213-2600 |
| Relation: |
https://eprints.whiterose.ac.uk/id/eprint/174433/1/1-s2.0-S2213260021001752-main.pdf; Docherty, AB, Mulholland, RH, Lone, NI et al. (377 more authors) (2021) Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK. The Lancet Respiratory Medicine, 9 (7). pp. 773-785. ISSN: 2213-2600 |
| Availability: |
https://eprints.whiterose.ac.uk/id/eprint/174433/ |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.AC0D730E |
| Database: |
BASE |