Clinical characteristics and outcomes of 952 hospitalized COVID-19 patients in The Netherlands: A retrospective cohort study

Abstract

Objective To describe clinical characteristics, disease course and outcomes in a large and well-documented cohort of hospitalized COVID-19 patients in the Netherlands. Methods We conducted a multicentre retrospective cohort study in The Netherlands including 952 of 1183 consecutively hospitalized patients that were admitted to participating hospitals between March 2nd, 2020, and May 22nd, 2020. Clinical characteristics and laboratory parameters upon admission and during hospitalization were collected until July 1st. Results The median age was 69 years (IQR 58–77 years) and 605 (63.6%) were male. Cardiovascular disease was present in 558 (58.6%) patients. The median time of onset of symptoms prior to hospitalization was 7 days (IQR 5–10). A non ICU admission policy was applicable in 312 (32.8%) patients and in 165 (56.3%) of the severely ill patients admitted to the ward. At admission and during hospitalization, severely ill patients had higher values of CRP, LDH, ferritin and D-dimer with higher neutrophil counts and lower lymphocyte counts. Overall in-hospital mortality was 25.1% and 183 (19.1%) patients were admitted to ICU, of whom 56 (30.6%) died. Patients aged ≥70 years had high mortality, both at the ward (52.4%) and ICU (47.4%). The median length of ICU stay was 8 days longer in patients aged ≥70 years compared to patients aged ≤60 years. Conclusion Hospitalized COVID-19 patients aged ≥70 years had high mortality and longer ICU stay compared to patients aged ≤60 years. These findings in combination with the patient burden of an ICU admission and possible long term complications after discharge should encourage us to further investigate the benefit of ICU admission in elderly and fragile COVID-19-patients.

Antibiotic prescriptions in the context of suspected bacterial respiratory tract superinfections in the COVID-19 era: a retrospective quantitative analysis of antibiotic consumption and identification of antibiotic prescription drivers

“…Overall, in our study population, the COVID-19 patients with an ICU stay showed more clinical signs of severe disease: higher inflammatory blood markers at admission (CRP, white blood cell count and ferritin), higher rate of fever at admission and higher oxygen need, which resulted in higher mortality as compared to patients solely admitted to the COVID-19 ward. This is in line with several observational COVID-19 studies [ 23 , 24 ]. At least one respiratory sample was available in no more than 29% of the admissions (18% forward admissions, 58% for ICU admissions).…”

The Influence of Infection and Colonization on Outcomes in Inpatients With COVID-19: Are We Forgetting Something?

“…The crude mortality rate in our study population of inpatients during the first year of the pandemic was 19.4%, within the range of other studies reporting rates of 4–28%, although generally other studies have had smaller populations ( 14 ), especially with regard to those admitted to the ICU ( 15 , 16 ). In our study, the median interval from onset to admission, not counting those with nosocomial infections, was slightly shorter at 4.6 days than the 7-day interval reported in a retrospective multicenter cohort study from the Netherlands ( 17 ), which may reflect a faster and more severe evolution in our patients. Unlike other studies ( 18 ), we did not find a higher risk in men after adjusting for comorbidity and age.…”

Cardiac Events Potentially Associated to Remdesivir: An Analysis from the European Spontaneous Adverse Event Reporting System

“…Notwithstanding remdesivir use, these clinical characteristics are consistent with those of hospitalized COVID-19 patients; in this regard, in fact, regardless the therapeutic strategy, several studies have tried to identify clinical and demographic characteristics, as well as potential factors of worst outcomes, associated to hospitalized COVID-19 patients. Through a retrospective cohort study, Pouw N and collaborators found that a median age of 69 years and the male gender were the prevalent demographic features of hospitalized COVID-19 patients in the Netherlands [ 12 ]. Moreover, Gavin W also concluded that an older age and being male may worsen outcomes in COVID-19 [ 13 ].…”