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SSRN; 2022.
Preprint in English | SSRN | ID: ppcovidwho-330616


Background: To determine whether neurological diagnoses during COVID-19 hospitalization are associated with adverse clinical outcomes. Methods: We investigated the clinical outcomes (length of hospital stay, COVID-19 disease severity based on published criteria, and mortality) of reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients hospitalized from 21 healthcare systems across 6 countries. Leveraging a unique federated multinational network in which electronic health records data are curated by local clinicians and informatics experts, we categorized patients according to the presence of central nervous system (CNS) or peripheral nervous system (PNS) diagnoses during COVID-19 hospitalization. We further identified comorbidities preceding hospitalization for COVID-19 up to 12 months. Each healthcare system locally performed covariate-adjusted survival analysis using Cox proportional hazard models to estimate the association between neurologic status and time to discharge, severe COVID-19 disease, and death. We performed a random-effects meta-analysis on locally generated results to estimate the risk of adverse clinical outcomes in patients with concurrent neurological diagnoses during COVID-19 hospitalization versus those with no neurological condition (NNC). Findings: We analyzed 87,869 hospitalized COVID-19 patients from January 2020 until September 2021, 13,518 (15%) with at least one CNS diagnosis, and 2,461 (3%) with at least one PNS diagnosis. The CNS group had longer hospital stay (median of 12 days), greater risk of severe disease, and higher risk of mortality than the NNC group. The PNS group also had longer hospital stay, but a similar risk of severe disease and lower risk of mortality than the NNC group. Patients with CNS diagnoses had a greater burden of pre-existing comorbidities, including neurologic conditions, when compared to the NNC group. Interpretation: Patients with CNS diagnoses during COVID-19 hospitalization harbored a greater burden of pre-existing comorbidities and had greater risk for adverse clinical outcomes.

Archives of Disease in Childhood ; 106(Suppl 3):A41, 2021.
Article in English | ProQuest Central | ID: covidwho-1573901


BackgroundWith the extensive impact of the COVID-19 pandemic and subsequent government interventions on the development, diagnosis and treatment of illnesses, building an understanding of ‘typical’ diagnosis trends at GOSH is critical for predicting future demands and potential clinical challenges. Seasonality analysis is an effective method with which one can explore, model and predict the occurrence of events over time when – as with many common diagnoses at GOSH – they generally exhibit a periodic trend over the year.MethodsTo investigate diagnosis seasonality at GOSH, we have extracted all diagnoses recorded in the Legacy and Epic systems, since the year 2010. We have developed an analytics pipeline that uses these data to compute historical rates for any given diagnosis, or group of diagnoses. Based on these diagnosis rates, our pipeline applies a widely used regressive, multiplicative, seasonal decomposition model with integrated model evaluation.ResultsFor the analysis, a total of 3,480,887 diagnosis events were considered across 29,529 patients between receiving a diagnosis between 1stJanuary 2010 and 30th September 2021. This exploration presents data on many of the common diagnoses at GOSH that exhibit a clear seasonal trend in combination with a statistically significant deviation from that trend since March 2020, likely due to the pandemic. In addition, we illustrate how the available data and model allow us to predict the diagnostic shortfall during the same period.

BMJ Paediatr Open ; 5(1): e001210, 2021.
Article in English | MEDLINE | ID: covidwho-1571209


In this retrospective observational study, we evaluated the impact of the COVID-19 pandemic in London on paediatric radiology activity, as a surrogate of overall hospital activity. We showed a large reduction in overall outpatient imaging activity: 49 250 records occurred in the 371 days post COVID-19 period compared with an expected 67 806 records pre COVID-19 period, representing 18 556 'missed' records. Governmental restrictions were associated with reductions in activity, with the largest reduction in activity during tiers 3 and 4 restrictions. Rescheduling such missed outpatients' appointments represents considerable resource planning and the associated clinical impact on paediatric healthcare remains to be determined.

COVID-19 , Radiology , Child , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Tertiary Care Centers