ABSTRACT
Introduction and Objectives Descriptions of clinical characteristics of patients hospitalized with coronavirus disease 2019 (COVID-19), their clinical course and short-term in- A nd outpatient outcomes in deprived urban populations in the United Kingdom is still relatively sparse. We describe the epidemiology, clinical course, experience of non-invasive ventilation and intensive care, mortality and short-term sequalae of patients admitted to two large District General Hospitals across a large East London NHS Trust during the first wave of the pandemic. Methods A retrospective analysis was carried out on a cohort of 1,946 patients admitted to two hospital sites during the first UK wave of the pandemic, including descriptive statistics and survival analysis. A more detailed analysis was undertaken of a subset of patients admitted across three Respiratory Units in the trust. Results Overall survival and rates of transfer to critical care are comparable to data from other urban centers. Increasing age, male sex and Asian ethnicity were associated with worse outcomes. Increasing severity of chest X-ray abnormalities trended with mortality. Radiological changes persisted in over 50% of cases at early follow up (6 weeks). Ongoing symptoms including hair loss, memory impairment, breathlessness, cough and fatigue were reported in 67% of survivors, with 42% of patients unable to return to work due to ongoing symptoms. At 12-week follow up, 5 patients out of 109 followed up required treatment for pneumonitis with 2 requiring re-admission. Associated complications such as MI, PE and CVA were seen in less than 2% overall postdischarge. Conclusions Whilst clinical features, course of illness and inhospital outcomes are broadly in line with published literature, our initial follow up data suggest there are ongoing sequalae of COVID-19 including, persistent symptoms and radiological abnormalities. These data highlight the ongoing need for localized pathways to provide physical, emotional and psychological support these patients. There are also potential economic ramifications from these patients' delayed return to work. Further data, including longer term follow up data, are necessary to improve our understanding of this novel pathogen and associated disease.
ABSTRACT
Introduction and ObjectivesDescriptions of clinical characteristics of patients hospitalized with coronavirus disease 2019 (COVID-19), their clinical course and short-term in- and outpatient outcomes in deprived urban populations in the United Kingdom is still relatively sparse. We describe the epidemiology, clinical course, experience of non-invasive ventilation and intensive care, mortality and short-term sequalae of patients admitted to two large District General Hospitals across a large East London NHS Trust during the first wave of the pandemic.MethodsA retrospective analysis was carried out on a cohort of 1,946 patients admitted to two hospital sites during the first UK wave of the pandemic, including descriptive statistics and survival analysis. A more detailed analysis was undertaken of a subset of patients admitted across three Respiratory Units in the trust.ResultsOverall survival and rates of transfer to critical care are comparable to data from other urban centers. Increasing age, male sex and Asian ethnicity were associated with worse outcomes. Increasing severity of chest X-ray abnormalities trended with mortality. Radiological changes persisted in over 50% of cases at early follow up (6 weeks). Ongoing symptoms including hair loss, memory impairment, breathlessness, cough and fatigue were reported in 67% of survivors, with 42% of patients unable to return to work due to ongoing symptoms. At 12-week follow up, 5 patients out of 109 followed up required treatment for pneumonitis with 2 requiring re-admission. Associated complications such as MI, PE and CVA were seen in less than 2% overall post-discharge.ConclusionsWhilst clinical features, course of illness and in-hospital outcomes are broadly in line with published literature, our initial follow up data suggest there are ongoing sequalae of COVID-19 including, persistent symptoms and radiological abnormalities. These data highlight the ongoing need for localized pathways to provide physical, emotional and psychological support these patients. There are also potential economic ramifications from these patients’ delayed return to work. Further data, including longer term follow up data, are necessary to improve our understanding of this novel pathogen and associated disease.