Characteristics and outcomes of an international cohort of 600000 hospitalized patients with COVID-19

Kartsonaki, C.; Baillie, J.K.; Garcia Barrio, N.; 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.; Goncalves, B.P.; Hall, M.; Hashmi, M.; Sim Lim Heng, B.; Antonia, H.; Jassat, W.; Pedrera Jimenez, M.; Laouenan, C.; Lissauer, S.; Martin-Loeches, I.; Mentre, F.; Merson, L.; Morton, B.; Munblit, D.; Nekliudov, N.A.; Nichol, A.D.; Singh Oinam, B.C.; Ong, D.; Panda, P.K.; Petrovic, M.; Pritchard, M.G.; Ramakrishnan, N.; Ramos, G.V.; Roger, C.; Sandulescu, O.; Semple, M.G.; Sharma, P.; Sigfrid, L.; Somers, E.C.; Streinu-Cercel, A.; Taccone, F.; Vecham, P.K.; Kumar Tirupakuzhi Vijayaraghavan, B.; Wei, J.; Wils, E.; Ci Wong, X.; Horby, P.; Rojek, A.; Olliaro, P.L.; Ali, A.; Abbas, A.; Sheryl Ann Abdukahil,; Nurul Najmee Abdulkadir,; Abe, R.; Abel, L.; Absil, L.; Acharya, S.; Acker, A.; Adam, E.; Adrião, D.; Saleh Al Ageel,; Ahmed, S.; Ainscough, K.; Airlangga, E.; Aisa, T.; Ali Ait Hssain,; Younes Ait Tamlihat,; Akimoto, T.; Akmal, E.; Eman Al Qasim,; Alalqam, R.; Alberti, A.; Al-Dabbous, T.; Alegesan, S.; Alegre, C.; Alessi, M.; Alex, B.; Alexandre, K.; Al-Fares, A.; Alfoudri, H.; Ali, I.; Ali, A.; Naseem Ali Shah,; Kazali Enagnon Alidjnou,; Aliudin, J.; Alkhafajee, Q.; Allavena, C.; Allou, N.; Altaf, A.; Alves, J.; Alves, R.; João Melo Alves,; Amaral, M.; Amira, N.; Ampaw, P.; Andini, R.; Andréjak, C.; Angheben, A.; Angoulvant, F.; Ansart, S.; Anthonidass, S.; Antonelli, M.; Carlos Alexandre Antunes De Brito,; Apriyana, A.; Arabi, Y.; Aragao, I.; Arancibia, F.; Araujo, C.; Arcadipane, A.; Archambault, P.; Arenz, L.; Arlet, J.; Arnold-Day, C.; Arora, L.; Arora, R.; Artaud-Macari, E.; Aryal, D.; Asensio, A.; Ashraf, M.; Asif, N.; Asim, M.; Jean Baptiste Assie,; Asyraf, A.; Atique, A.; M Udara Lakshan Attanyake, A.; Auchabie, J.; Aumaitre, H.; Auvet, A.; Azemar, L.; Azoulay, C.; Bach, B.; Bachelet, D.; Badr, C.; Baig, N.; J Kevin Baird,; Bak, E.; Bakakos, A.; Nazreen Abu Bakar,; Bal, A.; Balakrishnan, M.; Balan, V.; Bani-Sadr, F.; Barbalho, R.; Nicholas Yuri Barbosa,; Wendy, S.B.; Saef Umar Barnett,; Barnikel, M.; Barrasa, H.; Barrelet, A.; Barrigoto, C.; Bartoli, M.; Bashir, M.; Basmaci, R.; Muhammad Fadhli Hassin Basri,; Battaglini, D.; Bauer, J.; Diego Fernando Bautista Rincon,; Denisse Bazan Dow,; Bedossa, A.; Ker Hong Bee,; Begum, H.; Behilill, S.; Beishuizen, A.; Beljantsev, A.; Bellemare, D.; Beltrame, A.; Beatriz Amorim Beltrão,; Beluze, M.; Benech, N.; Lionel Eric Benjiman,; Benkerrou, D.; Bennett, S.; Bento, L.; Berdal, J.; Bergeaud, D.; Bergin, H.; José Luis Bernal Sobrino,; Bertoli, G.; Bertolino, L.; Bessis, S.; Bevilcaqua, S.; Bezulier, K.; Bhatt, A.; Bhavsar, K.; Bianco, C.; Farah Nadiah Bidin,; Moirangthem Bikram Singh,; Felwa Bin Humaid,; Mohd Nazlin Bin Kamarudin,; Bissuel, F.; Biston, P.; Bitker, L.; Bitton, J.; Blanco-Schweizer, P.; Blier, C.; Bloos, F.; Blot, M.; Boccia, F.; Bodenes, L.; 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Nathalie, M.D.; Deligiannis, I.; Dell'Amore, A.; Delmas, C.; Delobel, P.; Delsing, C.; Demonchy, E.; Denis, E.; Deplanque, D.; Depuydt, P.; Desai, M.; Descamps, D.; Desvallées, M.; Dewayanti, S.; Dhanger, P.; Diallo, A.; Diamantis, S.; Dias, A.; Juan Jose Diaz,; Diaz, P.; Diaz, R.; Didier, K.; Diehl, J.; Dieperink, W.; Dimet, J.; Dinot, V.; Diop, F.; Diouf, A.; Dishon, Y.; Djossou, F.; Annemarie, B.D.; Doherty, H.; Arjen, M.D.; Dong, A.; Donnelly, M.; Donohue, S.; Donohue, Y.; Donohue, C.; Doran, P.; Dorival, C.; D'Ortenzio, E.; James Joshua Douglas,; Douma, R.; Dournon, N.; Downer, T.; Downey, J.; Downing, M.; Drake, T.; Driscoll, A.; Dryden, M.; Dryden, M.; Claudio Duarte Fonseca,; Dubee, V.; Dubos, F.; Ducancelle, A.; Duculan, T.; Dudman, S.; Duggal, A.; Dunand, P.; Duplaix, M.; Durante-Mangoni, E.; Durham, L.; Dussol, B.; Duthoit, J.; Duval, X.; Anne Margarita Dyrhol-Riise,; Sim Choon Ean,; Echeverria-Villalobos, M.; Egan, S.; Eira, C.; Mohammed El Sanharawi,; Elapavaluru, S.; Elharrar, B.; 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Anja Grosse Lordemann,; Gruner, H.; Yusing, G.; Guedj, J.; Guego, M.; Guellec, D.; Guerguerian, A.; Guerreiro, D.; Guery, R.; Guillaumot, A.; Guilleminault, L.; Maisa Guimarães De Castro,; Guimard, T.; Haalboom, M.; Haber, D.; Habraken, H.; Hachemi, A.; Hackmann, A.; Hadri, N.; Haidri, F.; Hakak, S.; Hall, A.; Halpin, S.; Hameed, J.; Hamer, A.; Raph, L.H.; Hamidfar, R.; Hammond, T.; Lim Yuen Han,; Haniffa, R.; Kok Wei Hao,; Hardwick, H.; Ewen, M.H.; Harrison, J.; Samuel Bernard Ekow Harrison,; Hartman, A.; Mohd Shahnaz Hasan,; Hashmi, J.; Hayat, M.; Hayes, A.; Hays, L.; Heerman, J.; Heggelund, L.; Hendry, R.; Hennessy, M.; Henriquez-Trujillo, A.; Hentzien, M.; Hernandez-Montfort, J.; Hershey, A.; Hesstvedt, L.; Hidayah, A.; Higgins, E.; Higgins, D.; Higgins, R.; Hinchion, R.; Hinton, S.; Hiraiwa, H.; Hirkani, H.; Hitoto, H.; Yi Bin Ho,; Hoctin, A.; Hoffmann, I.; Wei Han Hoh,; Hoiting, O.; Holt, R.; Jan Cato Holter,; Juan Pablo Horcajada,; Hoshino, K.; Houas, I.; Catherine, L.H.; Houltham, S.; 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Lanza, M.; Laouénan, C.; Laribi, S.; Lariviere, D.; Lasry, S.; Lath, S.; Latif, N.; Launay, O.; Laureillard, D.; Lavie-Badie, Y.; Law, A.; Lawrence, T.; Lawrence, C.; Minh, L.; Clément Le Bihan,; Cyril Le Bris,; Georges Le Falher,; Lucie Le Fevre,; Quentin Le Hingrat,; Marion Le Maréchal,; Soizic Le Mestre,; Gwenaël Le Moal,; Vincent Le Moing,; Hervé Le Nagard,; Paul Le Turnier,; Leal, E.; Marta Leal Santos,; Todd, C.L.; Lee, J.; Lee, J.; Heng Gee Lee,; Biing Horng Lee,; Yi Lin Lee,; Su Hwan Lee,; Leeming, G.; Lefebvre, L.; Lefebvre, B.; Lefevre, B.; Legac, S.; Lelievre, J.; Lellouche, F.; Lemaignen, A.; Lemee, V.; Lemeur, A.; Lemmink, G.; Ha Sha Lene,; Lennon, J.; León, R.; Leone, M.; Leone, M.; Lepiller, Q.; Lescure, F.; Lesens, O.; Lesouhaitier, M.; Lester-Grant, A.; Levy, B.; Levy, Y.; Levy-Marchal, C.; Lewandowska, K.; L'Her, E.; Gianluigi Li Bassi,; Liang, J.; Liaquat, A.; Liegeon, G.; Wei Shen Lim,; Kah Chuan Lim,; Lima, C.; Lina, L.; Lina, B.; Lind, A.; Maja Katherine Lingad,; 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Martins, A.; Martins, N.; Caroline Martins Rego,; Martucci, G.; Martynenko, O.; Eva Miranda Marwali,; Marzukie, M.; Maslove, D.; Mason, S.; Masood, S.; Basri Mat Nor,; Matan, M.; Mathew, M.; Mathieu, D.; Mattei, M.; Matulevics, R.; Maulin, L.; Maxwell, M.; Maynar, J.; Mazzoni, T.; Natalie Mc Evoy,; Lisa Mc Sweeney,; Mcarthur, C.; Mcarthur, C.; Mccarthy, A.; Mccarthy, A.; Mccloskey, C.; Mcconnochie, R.; Mcdermott, S.; Sarah, E.M.; Mcelroy, A.; Mcelwee, S.; Mceneany, V.; Mcgeer, A.; Mckay, C.; Mckeown, J.; Kenneth, A.M.; Mcnally, P.; Mcnicholas, B.; Mcpartlan, E.; Meaney, E.; Mear-Passard, C.; Mechlin, M.; Meher, M.; Mehkri, O.; Mele, F.; Melo, L.; Memon, K.; Joao Joao Mendes,; Menkiti, O.; Menon, K.; Alexander, J.M.; Mercier, E.; Mercier, N.; Merckx, A.; Mergeay-Fabre, M.; Mergler, B.; Mesquita, A.; Meta, R.; Metwally, O.; Meybeck, A.; Meyer, D.; Alison, M.M.; Meysonnier, V.; Meziane, A.; Mezidi, M.; Michelanglei, C.; Michelet, I.; Mihelis, E.; Mihnovit, V.; Miranda-Maldonado, H.; Nor Arisah Misnan,; Tahira Jamal Mohamed,; Nik Nur Eliza Mohamed,; Moin, A.; Molina, D.; Molinos, E.; Molloy, B.; Mone, M.; Monteiro, A.; Montes, C.; Montrucchio, G.; Shona, C.M.; Moore, S.; Lina Morales Cely,; Moro, L.; Motherway, C.; Motos, A.; Mouquet, H.; Clara Mouton Perrot,; Moyet, J.; Mudara, C.; Aisha Kalsoom Mufti,; Ng Yong Muh,; Muhamad, D.; Mullaert, J.; Müller, F.; Karl Erik Müller,; Muneeb, S.; Munir, N.; Munshi, L.; Murphy, A.; Murphy, L.; Murphy, A.; Murris, M.; Murthy, S.; Musaab, H.; Muvindi, H.; Muyandy, G.; Dimitra Melia Myrodia,; Farah Nadia Mohd-Hanafiah,; Nagpal, D.; Nagrebetsky, A.; Narasimhan, M.; Narayanan, N.; Rashid Nasim Khan,; Nazerali-Maitland, A.; Neant, N.; Neb, H.; Nelwan, E.; Neto, R.; Neumann, E.; Pauline Yeung Ng,; Wing Yiu Ng,; Nghi, A.; Nguyen, D.; Orna Ni Choileain,; Niamh Ni Leathlobhair,; Nitayavardhana, P.; Nonas, S.; Nurul Amani Mohd Noordin,; Noret, M.; Nurul Faten Izzati Norharizam,; Norman, L.; Notari, A.; Noursadeghi, M.; Nowicka, K.; Nowinski, A.; Nseir, S.; 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doi:10.1093/IJE/DYAD012

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 689572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10years 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 similar to 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.

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Characteristics and outcomes of an international cohort of 600000 hospitalized patients with COVID-19

Kartsonaki, Christiana;Baillie, J. Kenneth;Garcia Barrio, Noelia;Baruch, Joaquin;Beane, Abigail;Blumberg, Lucille;Bozza, Fernando;Broadley, Tessa;Burrell, Aidan;Carson, Gail;Citarella, Barbara Wanjiru;Dagens, Andrew;Dankwa, Emmanuelle A.;Donnelly, Christl A.;Dunning, Jake;Elotmani, Loubna;Escher, Martina;Farshait, Nataly;Goffard, Jean-Christophe;Goncalves, Bronner P.;Hall, Matthew;Hashmi, Madiha;Sim Lim Heng, Benedict;Ho, Antonia;Jassat, Waasila;Pedrera Jimenez, Miguel;Laouenan, Cedric;Lissauer, Samantha;Martin-Loeches, Ignacio;Mentre, France;Merson, Laura;Morton, Ben;Munblit, Daniel;Nekliudov, Nikita A.;Nichol, Alistair D.;Singh Oinam, Budha Charan;Ong, David;Panda, Prasan Kumar;Petrovic, Michele;Pritchard, Mark G.;Ramakrishnan, Nagarajan;Ramos, Grazielle Viana;Roger, Claire;Sandulescu, Oana;Semple, Malcolm G.;Sharma, Pratima;Sigfrid, Louise;Somers, Emily C.;Streinu-Cercel, Anca;Taccone, Fabio;Vecham, Pavan Kumar;Wei, Jia;Wils, Evert-Jan;Ci Wong, Xin;Horby, Peter;Rojek, Amanda;Olliaro, Piero L.;Abbas Ali;Ali Abbas;Sheryl Ann Abdukahil;Nurul Najmee Abdulkadir;Ryuzo Abe;Laurent Abel;Lara Absil;Subhash Acharya;Andrew Acker;Elisabeth Adam;Diana Adrião;Saleh Al Ageel;Shakeel Ahmed;Kate Ainscough;Eka Airlangga;Tharwat Aisa;Ali Ait Hssain;Younes Ait Tamlihat;Takako Akimoto;Ernita Akmal;Eman Al Qasim;Razi Alalqam;Angela Alberti;Tala Al-Dabbous;Senthilkumar Alegesan;Cynthia Alegre;Marta Alessi;Beatrice Alex;Kévin Alexandre;Abdulrahman Al-Fares;Huda Alfoudri;Imran Ali;Adam Ali;Naseem Ali Shah;Kazali Enagnon Alidjnou;Jeffrey Aliudin;Qabas Alkhafajee;Clotilde Allavena;Nathalie Allou;Aneela Altaf;João Alves;Rita Alves;João Melo Alves;Maria Amaral;Nur Amira;Phoebe Ampaw;Roberto Andini;Claire Andréjak;Andrea Angheben;François Angoulvant;Séverine Ansart;Sivanesen Anthonidass;Massimo Antonelli;Carlos Alexandre Antunes de Brito;Ardiyan Apriyana;Yaseen Arabi;Irene Aragao;Francisco Arancibia;Carolline Araujo;Antonio Arcadipane;Patrick Archambault;Lukas Arenz;Jean-Benoît Arlet;Christel Arnold-Day;Lovkesh Arora;Rakesh Arora;Elise Artaud-Macari;Diptesh Aryal;Angel Asensio;Muhammad Ashraf;Namra Asif;Mohammad Asim;Jean Baptiste Assie;Amirul Asyraf;Anika Atique;A M Udara Lakshan Attanyake;Johann Auchabie;Hugues Aumaitre;Adrien Auvet;Laurène Azemar;Cecile Azoulay;Benjamin Bach;Delphine Bachelet;Claudine Badr;Nadia Baig;J Kevin Baird;Erica Bak;Agamemnon Bakakos;Nazreen Abu Bakar;Andriy Bal;Mohanaprasanth Balakrishnan;Valeria Balan;Firouzé Bani-Sadr;Renata Barbalho;Nicholas Yuri Barbosa;Wendy S Barclay;Saef Umar Barnett;Michaela Barnikel;Helena Barrasa;Audrey Barrelet;Cleide Barrigoto;Marie Bartoli;Mustehan Bashir;Romain Basmaci;Muhammad Fadhli Hassin Basri;Denise Battaglini;Jules Bauer;Diego Fernando Bautista Rincon;Denisse Bazan Dow;Alexandra Bedossa;Ker Hong Bee;Husna Begum;Sylvie Behilill;Albertus Beishuizen;Aleksandr Beljantsev;David Bellemare;Anna Beltrame;Beatriz Amorim Beltrão;Marine Beluze;Nicolas Benech;Lionel Eric Benjiman;Dehbia Benkerrou;Suzanne Bennett;Luís Bento;Jan-Erik Berdal;Delphine Bergeaud;Hazel Bergin;José Luis Bernal Sobrino;Giulia Bertoli;Lorenzo Bertolino;Simon Bessis;Sybille Bevilcaqua;Karine Bezulier;Amar Bhatt;Krishna Bhavsar;Claudia Bianco;Farah Nadiah Bidin;Moirangthem Bikram Singh;Felwa Bin Humaid;Mohd Nazlin Bin Kamarudin;François Bissuel;Patrick Biston;Laurent Bitker;Jonathan Bitton;Pablo Blanco-Schweizer;Catherine Blier;Frank Bloos;Mathieu Blot;Filomena Boccia;Laetitia Bodenes;Alice Bogaarts;Debby Bogaert;Anne-Hélène Boivin;Pierre-Adrien Bolze;François Bompart;Aurelius Bonfasius;Diogo Borges;Raphaël Borie;Hans Martin Bosse;Elisabeth Botelho-Nevers;Lila Bouadma;Olivier Bouchaud;Sabelline Bouchez;Dounia Bouhmani;Damien Bouhour;Kévin Bouiller;Laurence Bouillet;Camile Bouisse;Anne-Sophie Boureau;John Bourke;Maude Bouscambert;Aurore Bousquet;Jason Bouziotis;Bianca Boxma;Marielle Boyer-Besseyre;Maria Boylan;Axelle Braconnier;Cynthia Braga;Timo Brandenburger;Filipa Brás Monteiro;Luca Brazzi;Patrick Breen;Dorothy Breen;Patrick Breen;Kathy 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Zambrano;Alberto Zanella;Konrad Zawadka;Nurul Zaynah;Hiba Zayyad;Alexander Zoufaly;David Zucman

2023

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 689572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10years 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 similar to 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.

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	Parole chiave
	
				co-morbidities; cohort study; COVID-19; risk of death; SARS-CoV-2; symptoms; treatments
			
	Settori scientifico-disciplinari dell'articolo (validi dal 09/05/2024)
	
				Settore MEDS-23/A - Anestesiologia
			
	Data di pubblicazione
	
				2023
			
	Rivista in ANCE
	
				INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
			
	DOI
	
				https://dx.doi.org/10.1093/IJE/DYAD012
			
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				01 - Articolo su periodico

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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1190616

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