Observational study: prospective longitudinal cohort
In this prospective observational cohort study with rapid data gathering and near real-time analysis, the authors characterised the clinical features of patients admitted to hospital with Covid-19 in the United Kingdom during the growth phase of the first wave of the outbreak. Patients were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organisation (WHO) Clinical Characterisation Protocol UK (CCP-UK) study, and risk factors associated with mortality in hospital were explored. 20 133 hospital inpatients with Covid-19 were included from 208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020 with a minimal follow-up time of two weeks. The main outcome measures were: admission to critical care (high dependency unit or intensive care unit) and mortality in hospital. The median age of patients was 73 years (interquartile range 58-82, range 0-104). More men were admitted than women (men 60%; women 40%). The median duration of symptoms before admission was 4 days (interquartile range 1-8). The commonest comorbidities reported were chronic cardiac disease (31%), uncomplicated diabetes (21%), non-asthmatic chronic pulmonary disease (18%), and chronic kidney disease (16%). Overall, 41% of patients were discharged alive, 26% died, and 34% continued to receive care at the reporting date. 17% required admission to high dependency or intensive care units; of these, 28% were discharged alive, 32% died, and 41% continued to receive care at the reporting date. Of those receiving mechanical ventilation, 17% (276/1658) were discharged alive, 37% died, and 46% remained in hospital. Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital. The authors concluded that mortality was high, and independent risk factors were increasing age, male sex, and chronic comorbidity, including obesity.
View Article: https://www.bmj.com/content/369/bmj.m1985