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Ten months of temporal variation in the clinical journey of hospitalised patients with COVID-19
- Source :
- eLife, Vol 10 (2021), eLife, 10:e70970. ELIFE SCIENCES PUBLICATIONS LTD, eLife
- Publication Year :
- 2021
-
Abstract
- Background:There is potentially considerable variation in the nature and duration of the care provided to hospitalised patients during an infectious disease epidemic or pandemic. Improvements in care and clinician confidence may shorten the time spent as an inpatient, or the need for admission to an intensive care unit (ICU) or high dependency unit (HDU). On the other hand, limited resources at times of high demand may lead to rationing. Nevertheless, these variables may be used as static proxies for disease severity, as outcome measures for trials, and to inform planning and logistics.Methods:We investigate these time trends in an extremely large international cohort of 142,540 patients hospitalised with COVID-19. Investigated are: time from symptom onset to hospital admission, probability of ICU/HDU admission, time from hospital admission to ICU/HDU admission, hospital case fatality ratio (hCFR) and total length of hospital stay.Results:Time from onset to admission showed a rapid decline during the first months of the pandemic followed by peaks during August/September and December 2020. ICU/HDU admission was more frequent from June to August. The hCFR was lowest from June to August. Raw numbers for overall hospital stay showed little variation, but there is clear decline in time to discharge for ICU/HDU survivors.Conclusions:Our results establish that variables of these kinds have limitations when used as outcome measures in a rapidly evolving situation.Funding:This work was supported by the UK Foreign, Commonwealth and Development Office and Wellcome [215091/Z/18/Z] and the Bill & Melinda Gates Foundation [OPP1209135]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
- Subjects :
- Male
Outcome Assessment
global health
0601 Biochemistry and Cell Biology
law.invention
law
Case fatality rate
Pandemic
Epidemiology
Outcome Assessment, Health Care
80 and over
ISARIC Clinical Characterisation Group
Biology (General)
Outcome Assessment, Health Care/statistics & numerical data
Child
Aged, 80 and over
General Neuroscience
COVID-19
ICU
SARS-CoV-2
epidemiology
hospitalisation
human
medicine
viruses
Adolescent
Adult
Aged
Child, Preschool
Female
Hospitalization
Humans
Infant
Intensive Care Units
Length of Stay
Middle Aged
Retrospective Studies
Young Adult
General Medicine
Intensive care unit
Length of Stay/statistics & numerical data
Cohort
Intensive Care Units/statistics & numerical data
Medicine
Global health
Human
Viruses
Research Article
COVID-19/therapy
medicine.medical_specialty
Health Care/statistics & numerical data
Coronavirus disease 2019 (COVID-19)
QH301-705.5
Science
General Biochemistry, Genetics and Molecular Biology
Disease severity
Preschool
Hospitalization/statistics & numerical data
General Immunology and Microbiology
business.industry
SARS-CoV-2/pathogenicity
Health Care
Epidemiology and Global Health
Emergency medicine
Observational study
business
Subjects
Details
- Language :
- English
- ISSN :
- 2050084X
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- eLife
- Accession number :
- edsair.doi.dedup.....39d70bc2179ff78b85457b297ce5e351