Objective To 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 participants This 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 measures The 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. Results Baseline 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 (42.3% in March-April 2020 vs 30.8% in November 2020 to January 2021, p<0.001) and a moderate decrease in the intermediate-risk group (21.5% in March-April 2020 vs 14.3% in November 2020 to January 2021, p<0.001). Conclusions Admission 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.
|State||Published - Jun 1 2022|
Bibliographical noteFunding Information:
GMW is supported by NIH/NCATS UL1TR002541, NIH/NCATS UL1TR000005, NIH/NLM R01LM013345, and NIH/NHGRI 3U01HG008685-05S2. BWQT is supported by the National Medical Research Council Research Training Fellowship (MOH-000195-00). FJSV is supported by NIH/NCATS UL1TR001881. DAH is supported by NIH/NCATS UL1TR002240. KBW is supported by NIH/NHLBI R01 HL151643-01. SNM is supported by NIH/NCATS 5UL1TR001857-05 and NIH/NHGRI 5R01HG009174-04. NG is supported by NIH/NLM T15 LM007092. GSO is supported by NIH P30ES017885 and U24CA210967. ZX is supported by NIH/NINDS R01NS098023. SV is supported by NIH/NLM R01LM012095 and NIH/NCATS UL1TR001857. LPP is supported by NIH/NCATS CTSA Award #UL1TR002366. DLM is supported by NIH/NCATS CTSA Award #UL1-TR001878. RK is supported by NIH/NCATS CTSA award#UL1TR001998. NG-B is supported by the Carlos III Health Institute PI18/00981. AMS is supported by NIH/NHLBI K23HL148394 and L40HL148910 and NIH/NCATS UL1TR001420.
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- Public health
ASJC Scopus subject areas
- Medicine (all)