Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective cohort study.
Author(s)
Type
Journal Article
Abstract
COVID-19 has caused a major global pandemic and necessitated unprecedented public health restrictions in almost every country. Understanding risk factors for severe disease in hospitalised patients is critical as the pandemic progresses. This observational cohort study aimed to characterise the independent associations between the clinical outcomes of hospitalised patients and their demographics, comorbidities, blood tests and bedside observations. All patients admitted to Northwick Park Hospital, London, UK between 12 March and 15 April 2020 with COVID-19 were retrospectively identified. The primary outcome was death. Associations were explored using Cox proportional hazards modelling. The study included 981 patients. The mortality rate was 36.0%. Age (adjusted hazard ratio (aHR) 1.53), respiratory disease (aHR 1.37), immunosuppression (aHR 2.23), respiratory rate (aHR 1.28), hypoxia (aHR 1.36), Glasgow Coma Scale <15 (aHR 1.92), urea (aHR 2.67), alkaline phosphatase (aHR 2.53), C-reactive protein (aHR 1.15), lactate (aHR 2.67), platelet count (aHR 0.77) and infiltrates on chest radiograph (aHR 1.89) were all associated with mortality. These important data will aid clinical risk stratification and provide direction for further research.
Date Issued
2020-10-13
Date Acceptance
2020-10-01
Citation
Epidemiology and Infection, 2020, 148, pp.1-8
ISSN
0950-2688
Publisher
Cambridge University Press
Start Page
1
End Page
8
Journal / Book Title
Epidemiology and Infection
Volume
148
Copyright Statement
© The Author(s), 2020. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33046155
PII: S0950268820002472
Subjects
COVID-19
hospitalisation
severe disease
Aged
Aged, 80 and over
Betacoronavirus
COVID-19
Coronavirus Infections
Female
Hospitalization
Humans
London
Male
Middle Aged
Pandemics
Pneumonia, Viral
Proportional Hazards Models
Retrospective Studies
Risk Factors
SARS-CoV-2
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2020-10-13