Cohort profile: SARS-CoV-2/COVID-19 hospitalised patients in Switzerland

Abstract

BACKGROUND SARS-CoV-2/COVID-19, which emerged in China in late 2019, rapidly spread across the world with several million victims in 213 countries. Switzerland was severely hit by the virus, with 43,000 confirmed cases as of 1 September 2020. AIM In cooperation with the Federal Office of Public Health, we set up a surveillance database in February 2020 to monitor hospitalised patients with COVID-19, in addition to their mandatory reporting system. METHODS Patients hospitalised for more than 24 hours with a positive polymerase chain-reaction test, from 20 Swiss hospitals, are included. Data were collected in a customised case report form based on World Health Organisation recommendations and adapted to local needs. Nosocomial infections were defined as infections for which the onset of symptoms was more than 5 days after the patient’s admission date. RESULTS As of 1 September 2020, 3645 patients were included. Most patients were male (2168, 59.5%), and aged between 50 and 89 years (2778, 76.2%), with a median age of 68 (interquartile range 54–79). Community infections dominated with 3249 (89.0%) reports. Comorbidities were frequently reported, with hypertension (1481, 61.7%), cardiovascular diseases (948, 39.5%) and diabetes (660, 27.5%) being the most frequent in adults; respiratory diseases and asthma (4, 21.1%), haematological and oncological diseases (3, 15.8%) were the most frequent in children. Complications occurred in 2679 (73.4%) episodes, mostly respiratory diseases (2470, 93.2% in adults; 16, 55.2% in children), and renal (681, 25.7%) and cardiac (631, 23.8%) complications for adults. The second and third most frequent complications in children affected the digestive system and the liver (7, 24.1%). A targeted treatment was given in 1299 (35.6%) episodes, mostly with hydroxychloroquine (989, 76.1%). Intensive care units stays were reported in 578 (15.8%) episodes. A total of 527 (14.5%) deaths were registered, all among adults. CONCLUSION The surveillance system has been successfully initiated and provides a robust set of data for Switzerland by including about 80% (compared with official statistics) of SARS-CoV-2/COVID-19 hospitalised patients, with similar age and comorbidity distributions. It adds detailed information on the epidemiology, risk factors and clinical course of these cases and, therefore, is a valuable addition to the existing mandatory reporting.

Clinical outcomes of adults hospitalized for laboratory confirmed respiratory syncytial virus or influenza virus infection

“…In Switzerland, a prospective multicenter study of hospitalized influenza patients to evaluate the effectiveness of infection prevention measures has been initiated in 2015 [27]. Since this year, a national epidemiological surveillance on SARS-CoV-2 in hospitalized patients is also in place; and only recently, influenza virus infection was added to this surveillance [28]. With the growing recognition that RSV can cause a similarly severe course as influenza, emphasis on prevention in and out of the hospital, future intervention studies and prospective surveillance systems should include RSV patients.…”

Evolution of COVID-19 mortality over time: results from the Swiss hospital surveillance system (CH-SUR)

“…CH-SUR (COVID-19 Hospital Based Surveillance) is a prospective hospital surveillance system for COVID-19 coordinated by the Swiss Federal Office of Public Health (FOPH) and the Institute of Global Health (ISG) of the University of Geneva [11, 12], designed to capture detailed information on COVID-19 hospitalised patients in Switzerland. It includes patients hospitalised for more than 24h and diagnosed with COVID-19 confirmed by a laboratory test (e.g.…”

“…For each COVID-19 episode recorded in CH-SUR, various information on demographics, admission, clinical information (including comorbidities, complications, admission to intermediate care unit and/or intensive care unit -hereafter IMCU/ICU- and treatments) and follow-up (death, discharge or transfer) are collected. Further information on CH-SUR can be found elsewhere [11]. Of note, since CH-SUR was setup first for surveillance purposes, in a period of high burden for participating hospitals, priority was given to collection of data on admission and follow-up, to enable timely estimates of numbers regarding new cases and outcomes.…”

“…The anonymised data can be accessed through a multi-stage process described elsewhere [11]. Applicants must fill a concept-sheet and send it to the team in charge of the study.…”

“…To our knowledge, no study has been performed to investigate the evolution of COVID-19 related morbidity and mortality among hospitalized patients at a national scale in Switzerland, while also accounting for risk factors. Therefore, the aim of the present study is to investigate the trends in COVID-19 related mortality over time in Switzerland, comparing in particular the first and the second wave, using data from the COVID-19 Hospital-based Surveillance (CH-SUR) database [11].…”