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Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2

Authors :
Hong, Chuan
Zhang, Harrison
L'Yi, Sehi
Weber, Griffin
Avillach, Paul
Tan, Bryce
Gutiérrez-Sacristán, Alba
Bonzel, Clara-Lea
Palmer, Nathan
Malovini, Alberto
Tibollo, Valentina
Luo, Yuan
Hutch, Meghan
Liu, Molei
Bourgeois, Florence
Bellazzi, Riccardo
Chiovato, Luca
Sanz Vidorreta, Fernando
Le, Trang
Wang, Xuan
Yuan, William
Neuraz, Antoine
Benoit, Vincent
Moal, Bertrand
Morris, Michele
Hanauer, David
Maidlow, Sarah
Wagholikar, Kavishwar
Murphy, Shawn
Estiri, Hossein
Makoudjou, Adeline
Tippmann, Patric
Klann, Jeffery
Follett, Robert
Gehlenborg, Nils
Omenn, Gilbert
Xia, Zongqi
Dagliati, Arianna
Visweswaran, Shyam
Patel, Lav
Mowery, Danielle
Schriver, Emily
Samayamuthu, Malarkodi Jebathilagam
Kavuluru, Ramakanth
Lozano-Zahonero, Sara
Zöller, Daniela
Tan, Amelia
Tan, Byorn
Ngiam, Kee Yuan
Holmes, John
Schubert, Petra
Cho, Kelly
Ho, Yuk-Lam
Beaulieu-Jones, Brett
Pedrera-Jiménez, Miguel
García-Barrio, Noelia
Serrano-Balazote, Pablo
Kohane, Isaac
South, Andrew
Brat, Gabriel
Cai, T
Harvard Medical School [Boston] (HMS)
Brigham & Women’s Hospital [Boston] (BWH)
Columbia University [New York]
National University Hospital [Singapore] (NUH)
Istituti Clinici Scientifici Maugeri [Pavia] (IRCCS Pavia - ICS Maugeri)
Northwestern University [Chicago, Ill. USA]
Università degli Studi di Pavia = University of Pavia (UNIPV)
Laboratoire Magmas et Volcans (LMV)
Institut national des sciences de l'Univers (INSU - CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut de Recherche pour le Développement et la société-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-Observatoire de Physique du Globe de Clermont-Ferrand (OPGC)
Institut national des sciences de l'Univers (INSU - CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)
University of Science and Technology of China [Hefei] (USTC)
Université Paris Cité (UPCité)
Health data- and model- driven Knowledge Acquisition (HeKA)
Inria de Paris
Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138))
École pratique des hautes études (EPHE)
Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE)
Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)
Service d'informatique médicale et biostatistiques [CHU Necker]
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Northwestern University [Evanston]
Harvard T.H. Chan School of Public Health
David Geffen School of Medicine [Los Angeles]
University of California [Los Angeles] (UCLA)
University of California (UC)-University of California (UC)
University of Pennsylvania
École Pratique des Hautes Études (EPHE)
Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE)
Université de Bordeaux (UB)
University of Pittsburgh (PITT)
Pennsylvania Commonwealth System of Higher Education (PCSHE)
University of Michigan Medical School [Ann Arbor]
University of Michigan [Ann Arbor]
University of Michigan System-University of Michigan System
University of Michigan System
Massachusetts General Hospital [Boston]
University of Freiburg [Freiburg]
University of Kansas [Kansas City]
Hospital of the University of Pennsylvania (HUP)
Perelman School of Medicine
University of Pennsylvania-University of Pennsylvania
University of Kentucky (UK)
VA Boston Healthcare System
Hospital Universitario 12 de Octubre [Madrid]
Wake Forest University
Source :
BMJ Open, BMJ Open, 2022, 12 (6), pp.e057725. ⟨10.1136/bmjopen-2021-057725⟩
Publication Year :
2022
Publisher :
BMJ, 2022.

Abstract

ObjectiveTo assess changes in international mortality rates and laboratory recovery rates during hospitalisation for patients hospitalised with SARS-CoV-2 between the first wave (1 March to 30 June 2020) and the second wave (1 July 2020 to 31 January 2021) of the COVID-19 pandemic.Design, setting and participantsThis is a retrospective cohort study of 83 178 hospitalised patients admitted between 7 days before or 14 days after PCR-confirmed SARS-CoV-2 infection within the Consortium for Clinical Characterization of COVID-19 by Electronic Health Record, an international multihealthcare system collaborative of 288 hospitals in the USA and Europe. The laboratory recovery rates and mortality rates over time were compared between the two waves of the pandemic.Primary and secondary outcome measuresThe primary outcome was all-cause mortality rate within 28 days after hospitalisation stratified by predicted low, medium and high mortality risk at baseline. The secondary outcome was the average rate of change in laboratory values during the first week of hospitalisation.ResultsBaseline Charlson Comorbidity Index and laboratory values at admission were not significantly different between the first and second waves. The improvement in laboratory values over time was faster in the second wave compared with the first. The average C reactive protein rate of change was –4.72 mg/dL vs –4.14 mg/dL per day (p=0.05). The mortality rates within each risk category significantly decreased over time, with the most substantial decrease in the high-risk group (47.1% in March–April 2020 vs 30.8% in November 2020 to January 2021, pConclusionsAdmission profiles of patients hospitalised with SARS-CoV-2 infection did not differ greatly between the first and second waves of the pandemic, but there were notable differences in laboratory improvement rates during hospitalisation. Mortality risks among patients with similar risk profiles decreased over the course of the pandemic. The improvement in laboratory values and mortality risk was consistent across multiple countries.

Details

ISSN :
20446055
Volume :
12
Database :
OpenAIRE
Journal :
BMJ Open
Accession number :
edsair.doi.dedup.....7ec5b93998517ed6ff09be92e9166ae9
Full Text :
https://doi.org/10.1136/bmjopen-2021-057725