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Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study

The Lancet (British edition), 2021-07, Vol.398 (10296), p.223-237 [Peer Reviewed Journal]

2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license ;Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved. ;2021. The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. This work is published under https://creativecommons.org/licenses/by/3.0/ (theLicense”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Distributed under a Creative Commons Attribution 4.0 International License ;2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license 2021 ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(21)00799-6 ;PMID: 34274064

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Title:
Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study
Author: Knight, Stephen R ; Holden, Karl A ; Merson, Laura ; Russell, Clark D ; Solomon, Tom ; Carson, Gail ; Olliaro, Piero ; Semple, Malcolm G ; Alex, Beatrice ; Bach, Benjamin ; Dunning, Jake ; da Silva Filipe, Ana ; Horby, Peter W ; Law, Andrew ; Price, Nicholas ; Rambaut, Andrew ; Robertson, David L ; Scott, Janet T ; de Silva, Thushan ; Sigfrid, Louise ; Tedder, Richard S ; Thwaites, Ryan S ; Turtle, Lance CW ; Andrikopoulos, Petros ; Liggi, Sonia ; Sands, Caroline ; Fairfield, Cameron J ; Shaw, Catherine A ; Dalton, Jo ; Girvan, Michelle ; Hendry, Ross ; Greenhalf, William ; McDonald, Sarah E ; Booth, Laura ; Catterall, Benjamin WA ; Clarke, Emily A ; Dincarslan, Oslem ; Dyer, Philip ; Gunning, Philip ; Hartley, Catherine ; Jensen, Rebecca L ; Jones, Christopher B ; Khandaker, Shadia ; Lefteri, Daniella ; Livoti, Lucia A ; Middleton, Joanna ; Reynolds, Will ; Ridley, P. Matthew ; Shaw, Victoria E ; Tanianis-Hughes, Jolanta ; Trochu, Erwan ; Flaherty, Lisa ; Massey, Hannah ; Aldera, Erin L. ; Alegria, Ana ; Barnass, Stella ; Barrett, Nicholas ; Basude, Sneha ; Baxter, David ; Beadsworth, Michael ; Best, Nicola ; Burden, Tom ; Chukkambotla, Srikanth ; Cutino-Moguel, Maria-Teresa ; Douthwaite, Sam ; Fullerton, Duncan ; Garg, Atul ; Hawcutt, Daniel B ; Jennings, Paul ; Kaliappan, Agilan ; Kasipandian, Vidya ; Koduri, Gouri ; Laird, Steven ; Leiner, Tamas ; Little, Jeff ; McEwen, Ruth ; Morris, Craig ; Moses, Samuel ; Norris, Lillian ; Panchatsharam, Selva ; Pattison, Natalie ; Peters, Mark ; Price, David ; Prout, Rachel ; Richardson, Neil ; Rousseau, Guy ; Ryan, Brendan ; Sharma, Anil ; Stambach, Tom ; Stewart, Richard ; Thompson, Robert ; Tridente, Ascanio ; Vuylsteke, Alan ; Waddy, Sam ; Wake, Rachel ; Wilson, Lawrence ; Wiselka, Martin ; Wootton, Daniel G ; Workman, Andrew ; Young, Peter
Subjects: Age Factors ; Age groups ; Aged ; Cardiovascular Diseases ; Clinical Protocols ; Clinical Protocols - standards ; Comorbidity ; Complications ; Consent ; Consortia ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - epidemiology ; Epidemiology ; Female ; Females ; Health care ; Health care facilities ; Hospital Mortality ; Hospitalization ; Hospitals ; Human health and pathology ; Humans ; Illnesses ; Immunology ; Infections ; Infectious diseases ; Kidneys ; Life Sciences ; Long term planning ; Male ; Males ; Medical research ; Microbiology and Parasitology ; Morbidity ; Mortality ; Nervous System Diseases ; Neurological complications ; Pandemics ; Patients ; Pneumonia ; Population ; Prospective Studies ; Regression analysis ; Respiratory Tract Diseases ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Survival ; United Kingdom ; United Kingdom - epidemiology ; Ventilators ; Viral diseases ; Virology ; World Health Organization
Is Part Of: The Lancet (British edition), 2021-07, Vol.398 (10296), p.223-237
Description: COVID-19 is a multisystem disease and patients who survive might have in-hospital complications. These complications are likely to have important short-term and long-term consequences for patients, health-care utilisation, health-care system preparedness, and society amidst the ongoing COVID-19 pandemic. Our aim was to characterise the extent and effect of COVID-19 complications, particularly in those who survive, using the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK. We did a prospective, multicentre cohort study in 302 UK health-care facilities. Adult patients aged 19 years or older, with confirmed or highly suspected SARS-CoV-2 infection leading to COVID-19 were included in the study. The primary outcome of this study was the incidence of in-hospital complications, defined as organ-specific diagnoses occurring alone or in addition to any hallmarks of COVID-19 illness. We used multilevel logistic regression and survival models to explore associations between these outcomes and in-hospital complications, age, and pre-existing comorbidities. Between Jan 17 and Aug 4, 2020, 80 388 patients were included in the study. Of the patients admitted to hospital for management of COVID-19, 49·7% (36 367 of 73 197) had at least one complication. The mean age of our cohort was 71·1 years (SD 18·7), with 56·0% (41 025 of 73 197) being male and 81·0% (59 289 of 73 197) having at least one comorbidity. Males and those aged older than 60 years were most likely to have a complication (aged ≥60 years: 54·5% [16 579 of 30 416] in males and 48·2% [11 707 of 24 288] in females; aged <60 years: 48·8% [5179 of 10 609] in males and 36·6% [2814 of 7689] in females). Renal (24·3%, 17 752 of 73 197), complex respiratory (18·4%, 13 486 of 73 197), and systemic (16·3%, 11 895 of 73 197) complications were the most frequent. Cardiovascular (12·3%, 8973 of 73 197), neurological (4·3%, 3115 of 73 197), and gastrointestinal or liver (10·8%, 7901 of 73 197) complications were also reported. Complications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause a substantial strain on health and social care in the coming years. These data will help in the design and provision of services aimed at the post-hospitalisation care of patients with COVID-19. National Institute for Health Research and the UK Medical Research Council.
Publisher: England: Elsevier Ltd
Language: English
Identifier: ISSN: 0140-6736
EISSN: 1474-547X
DOI: 10.1016/S0140-6736(21)00799-6
PMID: 34274064
Source: ProQuest One Psychology
MEDLINE
ProQuest Central

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Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study

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