| Title: |
Inpatient COVID-19 mortality has reduced over time: Results from an observational cohort |
| Authors: |
Bechman, Katie; Yates, Mark; Mann, Kirsty; Nagra, Deepak; Smith, Laura-Jane; Rutherford, Andy I.; Patel, Amit; Periselneris, Jimstan; Walder, David; Dobson, Richard J. B.; Kraljevic, Zeljko; Teo, James H. T.; Bernal, William; Barker, Richard; Galloway, James B.; Norton, Sam |
| Contributors: |
Chen, Robert Jeenchen; medical research council |
| Source: |
PLOS ONE ; volume 17, issue 1, page e0261142 ; ISSN 1932-6203 |
| Publisher Information: |
Public Library of Science (PLoS) |
| Publication Year: |
2022 |
| Collection: |
PLOS Publications (via CrossRef) |
| Description: |
Background The Covid-19 pandemic in the United Kingdom has seen two waves; the first starting in March 2020 and the second in late October 2020. It is not known whether outcomes for those admitted with severe Covid were different in the first and second waves. Methods The study population comprised all patients admitted to a 1,500-bed London Hospital Trust between March 2020 and March 2021, who tested positive for Covid-19 by PCR within 3-days of admissions. Primary outcome was death within 28-days of admission. Socio-demographics (age, sex, ethnicity), hypertension, diabetes, obesity, baseline physiological observations, CRP, neutrophil, chest x-ray abnormality, remdesivir and dexamethasone were incorporated as co-variates. Proportional subhazards models compared mortality risk between wave 1 and wave 2. Cox-proportional hazard model with propensity score adjustment were used to compare mortality in patients prescribed remdesivir and dexamethasone. Results There were 3,949 COVID-19 admissions, 3,195 hospital discharges and 733 deaths. There were notable differences in age, ethnicity, comorbidities, and admission disease severity between wave 1 and wave 2. Twenty-eight-day mortality was higher during wave 1 (26.1% versus 13.1%). Mortality risk adjusted for co-variates was significantly lower in wave 2 compared to wave 1 [adjSHR 0.49 (0.37, 0.65) p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1371/journal.pone.0261142 |
| Availability: |
https://doi.org/10.1371/journal.pone.0261142; https://dx.plos.org/10.1371/journal.pone.0261142 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.B38CEAF5 |
| Database: |
BASE |