Clinical outcome, risk assessment, and seasonal variation in hospitalized COVID-19 patients-Results from the CORONA Germany study.
PLoS One
; 16(6): e0252867, 2021.
Article
in English
| MEDLINE | ID: covidwho-1278179
ABSTRACT
BACKGROUND:
After one year of the pandemic and hints of seasonal patterns, temporal variations of in-hospital mortality in COVID-19 are widely unknown. Additionally, heterogeneous data regarding clinical indicators predicting disease severity has been published. However, there is a need for a risk stratification model integrating the effects on disease severity and mortality to support clinical decision-making.METHODS:
We conducted a multicenter, observational, prospective, epidemiological cohort study at 45 hospitals in Germany. Until 1 January 2021, all hospitalized SARS CoV-2 positive patients were included. A comprehensive data set was collected in a cohort of seven hospitals. The primary objective was disease severity and prediction of mild, severe, and fatal cases. Ancillary analyses included a temporal analysis of all hospitalized COVID-19 patients for the entire year 2020.FINDINGS:
A total of 4704 COVID-19 patients were hospitalized with a mortality rate of 19% (890/4704). Rates of mortality, need for ventilation, pneumonia, and respiratory insufficiency showed temporal variations, whereas age had a strong influence on the course of mortality. In cohort conducting analyses, prognostic factors for fatal/severe disease were age (odds ratio (OR) 1.704, CI[1.221-2.377]), respiratory rate (OR 1.688, CI[1.222-2.333]), lactate dehydrogenase (LDH) (OR 1.312, CI[1.015-1.695]), C-reactive protein (CRP) (OR 2.132, CI[1.533-2.965]), and creatinine values (OR 2.573, CI[1.593-4.154].CONCLUSIONS:
Age, respiratory rate, LDH, CRP, and creatinine at baseline are associated with all cause death, and need for ventilation/ICU treatment in a nationwide series of COVID 19 hospitalized patients. Especially age plays an important prognostic role. In-hospital mortality showed temporal variation during the year 2020, influenced by age. TRIAL REGISTRATION NUMBER NCT04659187.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Seasons
/
Outcome Assessment, Health Care
/
Risk Assessment
/
SARS-CoV-2
/
COVID-19
/
Hospitalization
Type of study:
Cohort study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
PLoS One
Journal subject:
Science
/
Medicine
Year:
2021
Document Type:
Article
Affiliation country:
Journal.pone.0252867
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