Baseline phenotype and 30-day outcomes of people tested for COVID-19: an international network cohort including >3.32 million people tested with real-time PCR and >219,000 tested positive for SARS-CoV-2 in South Korea, Spain and the United States.

Early identification of symptoms and comorbidities most predictive of COVID-19 is critical to identify infection, guide policies to effectively contain the pandemic, and improve health systems' response. Here, we characterised socio-demographics and comorbidity in 3,316,107persons tested and 219,072 persons tested positive for SARS-CoV-2 since January 2020, and their key health outcomes in the month following the first positive test. Routine care data from primary care electronic health records (EHR) from Spain, hospital EHR from the United States (US), and claims data from South Korea and the US were used. The majority of study participants were women aged 18-65 years old. Positive/tested ratio varied greatly geographically (2.2:100 to 31.2:100) and over time (from 50:100 in February-April to 6.8:100 in May-June). Fever, cough and dyspnoea were the most common symptoms at presentation. Between 4%-38% required admission and 1-10.5% died within a month from their first positive test. Observed disparity in testing practices led to variable baseline characteristics and outcomes, both nationally (US) and internationally. Our findings highlight the importance of large scale characterization of COVID-19 international cohorts to inform planning and resource allocation including testing as countries face a second wave.
Competing Interests: COMPETING INTEREST STATEMENT All authors have completed the ICMJE uniform disclosure form, with the following declarations made: DPA reports grants from Amgen, grants and other from UCB Biopharma, grants from Johnson and Johnson, outside the submitted work. DM is supported by a Wellcome Trust Clinical Research Development Fellowship (Grant 214588/Z/18/Z) and reports grants from Chief Scientist Office (CSO), grants from Health Data Research UK (HDR-UK), grants from National Institute of Health Research (NIHR), and Tenovus outside the submitted work. SCY reports grants from Korean Ministry of Health & Welfare, grants from Korean Ministry of Trade, Industry & Energy, during the conduct of the study. AG reports personal fees from Regeneron Pharmaceuticals, outside the submitted work; and she is a full-time employee at Regeneron Pharmaceuticals. This work was not conducted at Regeneron Pharmaceuticals. Dr. Lane reports grants from Versus Arthritis, grants from Medical Research Council, outside the submitted work. MS reports grants from US National Science Foundation, grants from US National Institutes of Health, grants from IQVIA, personal fees from Janssen Research and Development, during the conduct of the study. HA reports personal fees from Eli Lilly and Company, outside the submitted work. AS reports personal fees from Janssen Research & Development, during the conduct of the study; personal fees from Janssen Research & Development, outside the submitted work. AS is a full-time employee of Janssen and shareholder of Johnson & Johnson. FD reports personal fees from Janssen Research & Development, during the conduct of the study; personal fees from Janssen Research & Development, outside the submitted work. KK reports she is an employee of IQVIA. CR reports he is an employee of IQVIA. FN was an employee of AstraZeneca until 2019 and holds some AstraZeneca shares. SF is an employee of Janssen Research and Development, a subsidiary of Johnson and Johnson. VS reports grant funding from the National Science Foundation, Agency for Healthcare Research and Quality, and the Arizona Board of Regents outside of the submitted work. The views expressed are those of the authors and do not necessarily represent the views or policy of the Department of Veterans Affairs or the United States Government. PR reports and is employee of Janssen Research and Development and shareholder of Johnson & Johnson. No other relationships or activities that could appear to have influenced the submitted work.