Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Christiana Kartsonaki; J. Kenneth Baillie; Noelia García Barrio; Joaquín Baruch; Abigail Beane; Lucille Blumberg; Fernando Bozza; Tessa Broadley; Aidan Burrell; Gail Carson; Barbara Wanjiru Citarella; Andrew Dagens; Emmanuelle A. Dankwa; Christl A. Donnelly; Jake Dunning; Loubna Elotmani; Martina Escher; Nataly Farshait; Jean Christophe Goffard; Bronner P. Gonçalves; Matthew Hall; Madiha Hashmi; Benedict Sim Lim Heng; Antonia Ho; Waasila Jassat; Miguel Pedrera Jiménez; Cedric Laouenan; Samantha Lissauer; Ignacio Martin-Loeches; France Mentré; Laura Merson; Ben Morton; Daniel Munblit; Nikita A. Nekliudov; Alistair D. Nichol; Budha Charan Singh Oinam; David Ong; Prasan Kumar Panda; Michele Petrovic; Mark G. Pritchard; Nagarajan Ramakrishnan; Grazielle Viana Ramos; Claire Roger; Oana Sandulescu; Malcolm G. Semple; Pratima Sharma; Louise Sigfrid; Emily C. Somers; Anca Streinu-Cercel; Fabio Taccone; Pavan Kumar Vecham; Bharath Kumar Tirupakuzhi Vijayaraghavan; Jia Wei; Evert Jan Wils; Xin Ci Wong; Peter Horby; Amanda Rojek; Piero L. Olliaro; ISARIC Clinical Characterisation Group

doi:10.1093/ije/dyad012

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Christiana Kartsonaki, J. Kenneth Baillie, Noelia García Barrio, Joaquín Baruch, Abigail Beane, Lucille Blumberg, Fernando Bozza, Tessa Broadley, Aidan Burrell, Gail Carson, Barbara Wanjiru Citarella, Andrew Dagens, Emmanuelle A. Dankwa, Christl A. Donnelly, Jake Dunning, Loubna Elotmani, Martina Escher, Nataly Farshait, Jean Christophe Goffard, Bronner P. GonçalvesMatthew Hall, Madiha Hashmi, Benedict Sim Lim Heng, Antonia Ho, Waasila Jassat, Miguel Pedrera Jiménez, Cedric Laouenan, Samantha Lissauer, Ignacio Martin-Loeches, France Mentré, Laura Merson, Ben Morton, Daniel Munblit, Nikita A. Nekliudov, Alistair D. Nichol, Budha Charan Singh Oinam, David Ong, Prasan Kumar Panda, Michele Petrovic, Mark G. Pritchard, Nagarajan Ramakrishnan, Grazielle Viana Ramos, Claire Roger, Oana Sandulescu, Malcolm G. Semple, Pratima Sharma, Louise Sigfrid, Emily C. Somers, Anca Streinu-Cercel, Fabio Taccone, Pavan Kumar Vecham, Bharath Kumar Tirupakuzhi Vijayaraghavan, Jia Wei, Evert Jan Wils, Xin Ci Wong, Peter Horby, Amanda Rojek, Piero L. Olliaro, ISARIC Clinical Characterisation Group

Research output: Contribution to journal › Article › Research › peer-review

39 Citations (Scopus)

Abstract

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world’s largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ~30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.

Original language	English
Pages (from-to)	355-376
Number of pages	22
Journal	International Journal of Epidemiology
Volume	52
Issue number	2
DOIs	https://doi.org/10.1093/ije/dyad012
Publication status	Published - Apr 2023

Keywords

co-morbidities
cohort study
COVID-19
risk of death
SARS-CoV-2
symptoms
treatments

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/ije/dyad012Licence: CC BY

Cite this

Kartsonaki, C., Baillie, J. K., Barrio, N. G., Baruch, J., Beane, A., Blumberg, L., Bozza, F., Broadley, T., Burrell, A., Carson, G., Citarella, B. W., Dagens, A., Dankwa, E. A., Donnelly, C. A., Dunning, J., Elotmani, L., Escher, M., Farshait, N., Goffard, J. C., ... ISARIC Clinical Characterisation Group (2023). Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19. International Journal of Epidemiology, 52(2), 355-376. https://doi.org/10.1093/ije/dyad012

@article{9dcdb7ed186b4b5180f3324843ef27c4,

title = "Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19",

abstract = "Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world{\textquoteright}s largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ~30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.",

keywords = "co-morbidities, cohort study, COVID-19, risk of death, SARS-CoV-2, symptoms, treatments",

author = "Christiana Kartsonaki and Baillie, {J. Kenneth} and Barrio, {Noelia Garc{\'i}a} and Joaqu{\'i}n Baruch and Abigail Beane and Lucille Blumberg and Fernando Bozza and Tessa Broadley and Aidan Burrell and Gail Carson and Citarella, {Barbara Wanjiru} and Andrew Dagens and Dankwa, {Emmanuelle A.} and Donnelly, {Christl A.} and Jake Dunning and Loubna Elotmani and Martina Escher and Nataly Farshait and Goffard, {Jean Christophe} and Gon{\c c}alves, {Bronner P.} and Matthew Hall and Madiha Hashmi and Heng, {Benedict Sim Lim} and Antonia Ho and Waasila Jassat and Jim{\'e}nez, {Miguel Pedrera} and Cedric Laouenan and Samantha Lissauer and Ignacio Martin-Loeches and France Mentr{\'e} and Laura Merson and Ben Morton and Daniel Munblit and Nekliudov, {Nikita A.} and Nichol, {Alistair D.} and Oinam, {Budha Charan Singh} and David Ong and Panda, {Prasan Kumar} and Michele Petrovic and Pritchard, {Mark G.} and Nagarajan Ramakrishnan and Ramos, {Grazielle Viana} and Claire Roger and Oana Sandulescu and Semple, {Malcolm G.} and Pratima Sharma and Louise Sigfrid and Somers, {Emily C.} and Anca Streinu-Cercel and Fabio Taccone and Vecham, {Pavan Kumar} and Vijayaraghavan, {Bharath Kumar Tirupakuzhi} and Jia Wei and Wils, {Evert Jan} and Wong, {Xin Ci} and Peter Horby and Amanda Rojek and Olliaro, {Piero L.} and Ali Abbas and Abdukahil, {Sheryl Ann} and Abdulkadir, {Nurul Najmee} and Ryuzo Abe and Laurent Abel and Lara Absil and Subhash Acharya and Andrew Acker and Elisabeth Adam and Diana Adri{\~a}o and {Al Ageel}, Saleh and Shakeel Ahmed and Kate Ainscough and Eka Airlangga and Tharwat Aisa and Hssain, {Ali Ait} and Tamlihat, {Younes Ait} and Takako Akimoto and Ernita Akmal and {Al Qasim}, Eman and Razi Alalqam and Angela Alberti and Tala Al-Dabbous and Senthilkumar Alegesan and Cynthia Alegre and Marta Alessi and Beatrice Alex and K{\'e}vin Alexandre and Abdulrahman Al-Fares and Huda Alfoudri and Imran Ali and Adam Ali and Shah, {Naseem Ali} and Alidjnou, {Kazali Enagnon} and Jeffrey Aliudin and Qabas Alkhafajee and Clotilde Allavena and Nathalie Allou and Aneela Altaf and Jo{\~a}o Alves and Rita Alves and Alves, {Jo{\~a}o Melo} and Maria Amaral and Nur Amira and Phoebe Ampaw and Roberto Andini and Claire Andr{\'e}jak and Andrea Angheben and Fran{\c c}ois Angoulvant and S{\'e}verine Ansart and Sivanesen Anthonidass and Massimo Antonelli and {Antunes De Brito}, {Carlos Alexandre} and Ardiyan Apriyana and Yaseen Arabi and Irene Aragao and Francisco Arancibia and Carolline Araujo and Antonio Arcadipane and Patrick Archambault and Lukas Arenz and Arlet, {Jean Beno{\^i}t} and Christel Arnold-Day and Lovkesh Arora and Rakesh Arora and Elise Artaud-Macari and Diptesh Aryal and Angel Asensio and Muhammad Ashraf and Namra Asif and Mohammad Asim and Assie, {Jean Baptiste} and Amirul Asyraf and Anika Atique and Attanyake, {A. M.Udara Lakshan} and Johann Auchabie and Hugues Aumaitre and Adrien Auvet and Laur{\`e}ne Azemar and Cecile Azoulay and Benjamin Bach and Delphine Bachelet and Claudine Badr and Nadia Baig and Baird, {J. Kevin} and Erica Bak and Agamemnon Bakakos and Bakar, {Nazreen Abu} and Andriy Bal and Mohanaprasanth Balakrishnan and Valeria Balan and Firouz{\'e} Bani-Sadr and Renata Barbalho and Barbosa, {Nicholas Yuri} and Barclay, {Wendy S.} and Barnett, {Saef Umar} and Michaela Barnikel and Helena Barrasa and Audrey Barrelet and Cleide Barrigoto and Marie Bartoli and Mustehan Bashir and Romain Basmaci and Basri, {Muhammad Fadhli Hassin} and Denise Battaglini and Jules Bauer and {Bautista Rincon}, {Diego Fernando} and {Bazan Dow}, Denisse and Alexandra Bedossa and Bee, {Ker Hong} and Husna Begum and Sylvie Behilill and Albertus Beishuizen and Aleksandr Beljantsev and David Bellemare and Anna Beltrame and Beltr{\~a}o, {Beatriz Amorim} and Marine Beluze and Nicolas Benech and Benjiman, {Lionel Eric} and Dehbia Benkerrou and Suzanne Bennett and Lu{\'i}s Bento and Berdal, {Jan Erik} and Delphine Bergeaud and Hazel Bergin and {Bernal Sobrino}, {Jos{\'e} Luis} and Giulia Bertoli and Lorenzo Bertolino and Simon Bessis and Sybille Bevilcaqua and Karine Bezulier and Amar Bhatt and Krishna Bhavsar and Claudia Bianco and Bidin, {Farah Nadiah} and {Bikram Singh}, Moirangthem and {Bin Humaid}, Felwa and {Bin Kamarudin}, {Mohd Nazlin} and Fran{\c c}ois Bissuel and Patrick Biston and Laurent Bitker and Jonathan Bitton and Pablo Blanco-Schweizer and Catherine Blier and Frank Bloos and Mathieu Blot and Filomena Boccia and Laetitia Bodenes and Alice Bogaarts and Debby Bogaert and Boivin, {Anne H{\'e}l{\`e}ne} and Bolze, {Pierre Adrien} and Fran{\c c}ois Bompart and Aurelius Bonfasius and Diogo Borges and Rapha{\"e}l Borie and Bosse, {Hans Martin} and Elisabeth Botelho-Nevers and Lila Bouadma and Olivier Bouchaud and Sabelline Bouchez and Dounia Bouhmani and Damien Bouhour and K{\'e}vin Bouiller and Laurence Bouillet and Camile Bouisse and Boureau, {Anne Sophie} and John Bourke and Maude Bouscambert and Aurore Bousquet and Jason Bouziotis and Bianca Boxma and Marielle Boyer-Besseyre and Maria Boylan and Axelle Braconnier and Cynthia Braga and Timo Brandenburger and {Br{\'a}s Monteiro}, Filipa and Luca Brazzi and Patrick Breen and Dorothy Breen and Kathy Brickell and Shaunagh Browne and Alex Browne and Nicolas Brozzi and Colin McArthur and Rachael Parke and {Serpa Neto}, Ary and Tony Trapani and Andrew Udy and Steve Webb and {ISARIC Clinical Characterisation Group}",

note = "Funding Information: This work was made possible by the UK Foreign, Commonwealth and Development Office; Wellcome (215091/Z/18/Z, 205228/Z/16/ Z, 220757/Z/20/Z); Bill & Melinda Gates Foundation (OPP1209135); UK Medical Research Council Clinical Research Training Fellowship (MR/V001671/1); the philanthropic support of the donors to the University of Oxford{\textquoteright}s COVID-19 Research Response Fund; CIHR Coronavirus Rapid Research Funding Opportunity (OV2170359) and the co-ordination in Canada by Sunnybrook Research Institute; endorsement of the Irish Critical Care—Clinical Trials Group, co-ordination in Ireland by the Irish Critical Care—Clinical Trials Network at University College Dublin and funding by the Health Research Board of Ireland (CTN-2014–12); the Rapid European COVID-19 Emergency Response research (RECOVER) (H2020 project 101003589) and European Clinical Research Alliance on Infectious Diseases (ECRAID) (965313); the COVID clinical management team, AIIMS, Rishikesh, India; the COVID-19 Clinical Management team, Manipal Hospital Whitefield, Bengaluru, India; Cambridge NIHR Biomedical Research Centre; the dedication and hard work of the Groote Schuur Hospital Covid ICU Team; support by the Groote Schuur nursing and University of Cape Town registrar bodies co-ordinated by the Division of Critical Care at the University of Cape Town; the Liverpool School of Tropical Medicine and the University of Oxford; the dedication and hard work of the Norwegian SARSCoV-2 study team; the Research Council of Norway (grant no. 312780) and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner; Imperial NIHR Biomedical Research Centre; the Comprehensive Local Research Networks of which PJMO is an NIHR Senior Investigator (NIHR201385); Innovative Medicines Initiative Joint Undertaking under Grant Agreement No. 115523 COMBACTE, resources of which are composed of financial contribution from the European Union{\textquoteright}s Seventh Framework Programme (FP7/2007– 2013) and EFPIA companies, in-kind contribution; the French COVID cohort (NCT04262921) is sponsored by INSERM and is funded by the REACTing (REsearch & ACtion emergING infectious diseases) consortium and by a grant of the French Ministry of Health (PHRC n 20–0424); Stiftungsfonds zur F{\"o}rderung der Bek{\"a}mpfung der Tuberkulose und anderer Lungenkrankheiten of the City of Vienna (project no. APCOV22BGM); Italian Ministry of Health {\textquoteleft}Fondi Ricerca corrente–L1P6{\textquoteright} to IRCCS Ospedale Sacro Cuore–Don Calabria; Australian Department of Health grant (3273191); Gender Equity Strategic Fund at University of Queensland, Artificial Intelligence for Pandemics (A14PAN) at University of Queensland, the Australian Research Council Centre of Excellence for Engineered Quantum Systems (EQUS, CE170100009), the Prince Charles Hospital Foundation, Australia; grants from Instituto de Salud Carlos III, Ministerio de Ciencia, Spain; Brazil, National Council for Scientific and Technological Development (scholarship no. 303953/2018–7); the Firland Foundation, Shoreline, Washington, USA; a grant from foundation Bevordering Onderzoek Franciscus; the South Eastern Norway Health Authority and the Research Council of Norway; and preparedness work conducted by the Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection. Data and Material provision was supported by grants from the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059) and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with PHE (award no. 200907), NIHR HPRU in Respiratory Infections at Imperial College London with PHE (award no. 200927), Liverpool Experimental Cancer Medicine Centre (grant no. C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (award no. IS-BRC-1215–20013) and NIHR Clinical Research Network providing infrastructure support. Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the International Epidemiological Association.",

year = "2023",

month = apr,

doi = "10.1093/ije/dyad012",

language = "English",

volume = "52",

pages = "355--376",

journal = "International Journal of Epidemiology",

issn = "0300-5771",

publisher = "Oxford University Press",

number = "2",

}

Kartsonaki, C, Baillie, JK, Barrio, NG, Baruch, J, Beane, A, Blumberg, L, Bozza, F, Broadley, T, Burrell, A, Carson, G, Citarella, BW, Dagens, A, Dankwa, EA, Donnelly, CA, Dunning, J, Elotmani, L, Escher, M, Farshait, N, Goffard, JC, Gonçalves, BP, Hall, M, Hashmi, M, Heng, BSL, Ho, A, Jassat, W, Jiménez, MP, Laouenan, C, Lissauer, S, Martin-Loeches, I, Mentré, F, Merson, L, Morton, B, Munblit, D, Nekliudov, NA, Nichol, AD, Oinam, BCS, Ong, D, Panda, PK, Petrovic, M, Pritchard, MG, Ramakrishnan, N, Ramos, GV, Roger, C, Sandulescu, O, Semple, MG, Sharma, P, Sigfrid, L, Somers, EC, Streinu-Cercel, A, Taccone, F, Vecham, PK, Vijayaraghavan, BKT, Wei, J, Wils, EJ, Wong, XC, Horby, P, Rojek, A, Olliaro, PL & ISARIC Clinical Characterisation Group 2023, 'Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19', International Journal of Epidemiology, vol. 52, no. 2, pp. 355-376. https://doi.org/10.1093/ije/dyad012

TY - JOUR

T1 - Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

AU - Kartsonaki, Christiana

AU - Baillie, J. Kenneth

AU - Barrio, Noelia García

AU - Baruch, Joaquín

AU - Beane, Abigail

AU - Blumberg, Lucille

AU - Bozza, Fernando

AU - Broadley, Tessa

AU - Burrell, Aidan

AU - Carson, Gail

AU - Citarella, Barbara Wanjiru

AU - Dagens, Andrew

AU - Dankwa, Emmanuelle A.

AU - Donnelly, Christl A.

AU - Dunning, Jake

AU - Elotmani, Loubna

AU - Escher, Martina

AU - Farshait, Nataly

AU - Goffard, Jean Christophe

AU - Gonçalves, Bronner P.

AU - Hall, Matthew

AU - Hashmi, Madiha

AU - Heng, Benedict Sim Lim

AU - Ho, Antonia

AU - Jassat, Waasila

AU - Jiménez, Miguel Pedrera

AU - Laouenan, Cedric

AU - Lissauer, Samantha

AU - Martin-Loeches, Ignacio

AU - Mentré, France

AU - Merson, Laura

AU - Morton, Ben

AU - Munblit, Daniel

AU - Nekliudov, Nikita A.

AU - Nichol, Alistair D.

AU - Oinam, Budha Charan Singh

AU - Ong, David

AU - Panda, Prasan Kumar

AU - Petrovic, Michele

AU - Pritchard, Mark G.

AU - Ramakrishnan, Nagarajan

AU - Ramos, Grazielle Viana

AU - Roger, Claire

AU - Sandulescu, Oana

AU - Semple, Malcolm G.

AU - Sharma, Pratima

AU - Sigfrid, Louise

AU - Somers, Emily C.

AU - Streinu-Cercel, Anca

AU - Taccone, Fabio

AU - Vecham, Pavan Kumar

AU - Vijayaraghavan, Bharath Kumar Tirupakuzhi

AU - Wei, Jia

AU - Wils, Evert Jan

AU - Wong, Xin Ci

AU - Horby, Peter

AU - Rojek, Amanda

AU - Olliaro, Piero L.

AU - Abbas, Ali

AU - Abdukahil, Sheryl Ann

AU - Abdulkadir, Nurul Najmee

AU - Abe, Ryuzo

AU - Abel, Laurent

AU - Absil, Lara

AU - Acharya, Subhash

AU - Acker, Andrew

AU - Adam, Elisabeth

AU - Adrião, Diana

AU - Al Ageel, Saleh

AU - Ahmed, Shakeel

AU - Ainscough, Kate

AU - Airlangga, Eka

AU - Aisa, Tharwat

AU - Hssain, Ali Ait

AU - Tamlihat, Younes Ait

AU - Akimoto, Takako

AU - Akmal, Ernita

AU - Al Qasim, Eman

AU - Alalqam, Razi

AU - Alberti, Angela

AU - Al-Dabbous, Tala

AU - Alegesan, Senthilkumar

AU - Alegre, Cynthia

AU - Alessi, Marta

AU - Alex, Beatrice

AU - Alexandre, Kévin

AU - Al-Fares, Abdulrahman

AU - Alfoudri, Huda

AU - Ali, Imran

AU - Ali, Adam

AU - Shah, Naseem Ali

AU - Alidjnou, Kazali Enagnon

AU - Aliudin, Jeffrey

AU - Alkhafajee, Qabas

AU - Allavena, Clotilde

AU - Allou, Nathalie

AU - Altaf, Aneela

AU - Alves, João

AU - Alves, Rita

AU - Alves, João Melo

AU - Amaral, Maria

AU - Amira, Nur

AU - Ampaw, Phoebe

AU - Andini, Roberto

AU - Andréjak, Claire

AU - Angheben, Andrea

AU - Angoulvant, François

AU - Ansart, Séverine

AU - Anthonidass, Sivanesen

AU - Antonelli, Massimo

AU - Antunes De Brito, Carlos Alexandre

AU - Apriyana, Ardiyan

AU - Arabi, Yaseen

AU - Aragao, Irene

AU - Arancibia, Francisco

AU - Araujo, Carolline

AU - Arcadipane, Antonio

AU - Archambault, Patrick

AU - Arenz, Lukas

AU - Arlet, Jean Benoît

AU - Arnold-Day, Christel

AU - Arora, Lovkesh

AU - Arora, Rakesh

AU - Artaud-Macari, Elise

AU - Aryal, Diptesh

AU - Asensio, Angel

AU - Ashraf, Muhammad

AU - Asif, Namra

AU - Asim, Mohammad

AU - Assie, Jean Baptiste

AU - Asyraf, Amirul

AU - Atique, Anika

AU - Attanyake, A. M.Udara Lakshan

AU - Auchabie, Johann

AU - Aumaitre, Hugues

AU - Auvet, Adrien

AU - Azemar, Laurène

AU - Azoulay, Cecile

AU - Bach, Benjamin

AU - Bachelet, Delphine

AU - Badr, Claudine

AU - Baig, Nadia

AU - Baird, J. Kevin

AU - Bak, Erica

AU - Bakakos, Agamemnon

AU - Bakar, Nazreen Abu

AU - Bal, Andriy

AU - Balakrishnan, Mohanaprasanth

AU - Balan, Valeria

AU - Bani-Sadr, Firouzé

AU - Barbalho, Renata

AU - Barbosa, Nicholas Yuri

AU - Barclay, Wendy S.

AU - Barnett, Saef Umar

AU - Barnikel, Michaela

AU - Barrasa, Helena

AU - Barrelet, Audrey

AU - Barrigoto, Cleide

AU - Bartoli, Marie

AU - Bashir, Mustehan

AU - Basmaci, Romain

AU - Basri, Muhammad Fadhli Hassin

AU - Battaglini, Denise

AU - Bauer, Jules

AU - Bautista Rincon, Diego Fernando

AU - Bazan Dow, Denisse

AU - Bedossa, Alexandra

AU - Bee, Ker Hong

AU - Begum, Husna

AU - Behilill, Sylvie

AU - Beishuizen, Albertus

AU - Beljantsev, Aleksandr

AU - Bellemare, David

AU - Beltrame, Anna

AU - Beltrão, Beatriz Amorim

AU - Beluze, Marine

AU - Benech, Nicolas

AU - Benjiman, Lionel Eric

AU - Benkerrou, Dehbia

AU - Bennett, Suzanne

AU - Bento, Luís

AU - Berdal, Jan Erik

AU - Bergeaud, Delphine

AU - Bergin, Hazel

AU - Bernal Sobrino, José Luis

AU - Bertoli, Giulia

AU - Bertolino, Lorenzo

AU - Bessis, Simon

AU - Bevilcaqua, Sybille

AU - Bezulier, Karine

AU - Bhatt, Amar

AU - Bhavsar, Krishna

AU - Bianco, Claudia

AU - Bidin, Farah Nadiah

AU - Bikram Singh, Moirangthem

AU - Bin Humaid, Felwa

AU - Bin Kamarudin, Mohd Nazlin

AU - Bissuel, François

AU - Biston, Patrick

AU - Bitker, Laurent

AU - Bitton, Jonathan

AU - Blanco-Schweizer, Pablo

AU - Blier, Catherine

AU - Bloos, Frank

AU - Blot, Mathieu

AU - Boccia, Filomena

AU - Bodenes, Laetitia

AU - Bogaarts, Alice

AU - Bogaert, Debby

AU - Boivin, Anne Hélène

AU - Bolze, Pierre Adrien

AU - Bompart, François

AU - Bonfasius, Aurelius

AU - Borges, Diogo

AU - Borie, Raphaël

AU - Bosse, Hans Martin

AU - Botelho-Nevers, Elisabeth

AU - Bouadma, Lila

AU - Bouchaud, Olivier

AU - Bouchez, Sabelline

AU - Bouhmani, Dounia

AU - Bouhour, Damien

AU - Bouiller, Kévin

AU - Bouillet, Laurence

AU - Bouisse, Camile

AU - Boureau, Anne Sophie

AU - Bourke, John

AU - Bouscambert, Maude

AU - Bousquet, Aurore

AU - Bouziotis, Jason

AU - Boxma, Bianca

AU - Boyer-Besseyre, Marielle

AU - Boylan, Maria

AU - Braconnier, Axelle

AU - Braga, Cynthia

AU - Brandenburger, Timo

AU - Brás Monteiro, Filipa

AU - Brazzi, Luca

AU - Breen, Patrick

AU - Breen, Dorothy

AU - Brickell, Kathy

AU - Browne, Shaunagh

AU - Browne, Alex

AU - Brozzi, Nicolas

AU - McArthur, Colin

AU - Parke, Rachael

AU - Serpa Neto, Ary

AU - Trapani, Tony

AU - Udy, Andrew

AU - Webb, Steve

AU - ISARIC Clinical Characterisation Group

N1 - Funding Information: This work was made possible by the UK Foreign, Commonwealth and Development Office; Wellcome (215091/Z/18/Z, 205228/Z/16/ Z, 220757/Z/20/Z); Bill & Melinda Gates Foundation (OPP1209135); UK Medical Research Council Clinical Research Training Fellowship (MR/V001671/1); the philanthropic support of the donors to the University of Oxford’s COVID-19 Research Response Fund; CIHR Coronavirus Rapid Research Funding Opportunity (OV2170359) and the co-ordination in Canada by Sunnybrook Research Institute; endorsement of the Irish Critical Care—Clinical Trials Group, co-ordination in Ireland by the Irish Critical Care—Clinical Trials Network at University College Dublin and funding by the Health Research Board of Ireland (CTN-2014–12); the Rapid European COVID-19 Emergency Response research (RECOVER) (H2020 project 101003589) and European Clinical Research Alliance on Infectious Diseases (ECRAID) (965313); the COVID clinical management team, AIIMS, Rishikesh, India; the COVID-19 Clinical Management team, Manipal Hospital Whitefield, Bengaluru, India; Cambridge NIHR Biomedical Research Centre; the dedication and hard work of the Groote Schuur Hospital Covid ICU Team; support by the Groote Schuur nursing and University of Cape Town registrar bodies co-ordinated by the Division of Critical Care at the University of Cape Town; the Liverpool School of Tropical Medicine and the University of Oxford; the dedication and hard work of the Norwegian SARSCoV-2 study team; the Research Council of Norway (grant no. 312780) and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner; Imperial NIHR Biomedical Research Centre; the Comprehensive Local Research Networks of which PJMO is an NIHR Senior Investigator (NIHR201385); Innovative Medicines Initiative Joint Undertaking under Grant Agreement No. 115523 COMBACTE, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007– 2013) and EFPIA companies, in-kind contribution; the French COVID cohort (NCT04262921) is sponsored by INSERM and is funded by the REACTing (REsearch & ACtion emergING infectious diseases) consortium and by a grant of the French Ministry of Health (PHRC n 20–0424); Stiftungsfonds zur Förderung der Bekämpfung der Tuberkulose und anderer Lungenkrankheiten of the City of Vienna (project no. APCOV22BGM); Italian Ministry of Health ‘Fondi Ricerca corrente–L1P6’ to IRCCS Ospedale Sacro Cuore–Don Calabria; Australian Department of Health grant (3273191); Gender Equity Strategic Fund at University of Queensland, Artificial Intelligence for Pandemics (A14PAN) at University of Queensland, the Australian Research Council Centre of Excellence for Engineered Quantum Systems (EQUS, CE170100009), the Prince Charles Hospital Foundation, Australia; grants from Instituto de Salud Carlos III, Ministerio de Ciencia, Spain; Brazil, National Council for Scientific and Technological Development (scholarship no. 303953/2018–7); the Firland Foundation, Shoreline, Washington, USA; a grant from foundation Bevordering Onderzoek Franciscus; the South Eastern Norway Health Authority and the Research Council of Norway; and preparedness work conducted by the Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection. Data and Material provision was supported by grants from the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059) and by the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with PHE (award no. 200907), NIHR HPRU in Respiratory Infections at Imperial College London with PHE (award no. 200927), Liverpool Experimental Cancer Medicine Centre (grant no. C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (award no. IS-BRC-1215–20013) and NIHR Clinical Research Network providing infrastructure support. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the International Epidemiological Association.

PY - 2023/4

Y1 - 2023/4

N2 - Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world’s largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ~30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.

AB - Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world’s largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ~30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death.

KW - co-morbidities

KW - cohort study

KW - COVID-19

KW - risk of death

KW - SARS-CoV-2

KW - symptoms

KW - treatments

UR - http://www.scopus.com/inward/record.url?scp=85159603496&partnerID=8YFLogxK

U2 - 10.1093/ije/dyad012

DO - 10.1093/ije/dyad012

M3 - Article

C2 - 36850054

AN - SCOPUS:85159603496

SN - 0300-5771

VL - 52

SP - 355

EP - 376

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

IS - 2

ER -

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

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UN SDGs

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