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.
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Baillie, J., Kartsonaki, C., Barrio, N., Baruch, J., Beane, A., Blumberg, L., Bozza, F., Broadley, T., Burrell, A., Carson, G., Citarella, B., Dagens, A., Dankwa, E., Donnelly, C., Dunning, J., Elotmani, L., Escher, M., Farshait, N., Goffard, J., Gonçalves, B., Hall, M., Hashmi, M., Heng, B., Ho, A., Jassat, W., Jiménez, M., Laouenan, C., Lissauer, S., Martin-Loeches, I. & Mentré, F. 2023, 'Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19', International Journal of Epidemiology, article no: dyad012. https://doi.org/10.1093/ije/dyad012