Patient Factors and Temporal Trends Associated with COVID-19 In-Hospital Mortality in England: An Observational Study Using Administrative Data

Navaratnam, Annakan; Gray, William K.; Day, Jamie; Wendon, Julia; Briggs, Tim

doi:10.2139/ssrn.3706052

Cited by 44 publications

(67 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The median duration of hospital admission was between 15–20 days and of those admitted with diabetes, 11 (58%) survived to discharge. These figures are similar to other patients admitted with COVID‐19 who did not have diabetes and national figures overall 38 . However, given the locally employed triage, patients admitted to Singleton Hospital reflected an older and frailer cohort overall.…”

Section: Local Experiencesupporting

confidence: 74%

A physician's approach and experience of managing patients with diabetes during COVID‐19

et al. 2021

View full text Add to dashboard Cite

Since the start of the COVID‐19 pandemic, the vulnerability of people with diabetes has been recognised with a greater risk of morbidity and mortality compared to the general population. The outcomes associated with diabetes may be a consequence of an impaired immune response, presence of composite comorbidities or the multi‐organ infectivity of SARS‐CoV‐2 affecting the pancreas. Emerging evidence suggests that both acute and chronic hyperglycaemia can exacerbate the clinical consequences of COVID‐19. Thus, the role of health care professionals in the observation and management of glucose control is increasingly recognised in people with diabetes in both the acute and chronic setting. In this review, we highlight the key biological implications of SARS‐CoV‐2 infection in people with diabetes, the clinical outcomes of COVID‐19 in people with diabetes and management principles with respect to glucose control including our local experiences. Copyright © 2021 John Wiley & Sons.

show abstract

Section: Local Experiencesupporting

confidence: 74%

A physician's approach and experience of managing patients with diabetes during COVID‐19

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The data from Saez-Giménez B. et al 3 provide exciting clinical evidence in support of our model, as acute lung denervation due to transplant surgery was associated with adverse outcomes from COVID-19. Indeed, in line with our proposed model, these data suggest that lack of lung innervation could worsen SARS-CoV-2 infection outcomes, mirroring the poor COVID-19 prognosis observed in elderly individuals 6 , in whom the vagal tone is reduced.…”

supporting

confidence: 82%

Reply to: Neuroimmune interactions and COVID-19 in lung transplant recipients

Virgiliis

Giovanni

2021

Nat Rev Neurol

View full text Add to dashboard Cite

“…We conducted two random effect multivariable logistic regression analyses. The first analysis assessed risk factors for in-hospital mortality accounting for wave period, and the second compared the characteristics of hospitalised COVID- 19 We used the Chi squared test to assess the difference in CFR at the peak of the first and second wave. In addition, we compared the exponential growth rate of the first and the second wave.…”

Section: Discussionmentioning

confidence: 99%

“…18Based on global trends, it might have been expected that in-hospital COVID-19 mortality in South Africa would have decreased in the second wave. In most countries, the second wave of COVID-19 had a higher number of cases but lower mortality (19)(20)(21)(22)(23)(24). Improved outcomes during the second wave were likely a result of introduction of interventions such as remdesivir (25), dexamethasone (26), high-flow oxygen (27), greater use of thromboprophylaxis (28) as well as non-pharmacologic treatments such as placing the patient in the prone position.…”

Section: Discussionmentioning

confidence: 99%

Increased mortality among individuals hospitalised with COVID-19 during the second wave in South Africa

Jassat

Mudara

Ozougwu

et al. 2021

Preprint

View full text Add to dashboard Cite

Introduction: South Africa experienced its first wave of COVID-19 peaking in mid-July 2020 and a larger second wave peaking in January 2021, in which the SARS-CoV-2 501Y.V2 lineage predominated. We aimed to compare in-hospital mortality and other patient characteristics between the first and second waves of COVID-19. Methods: We analysed data from the DATCOV national active surveillance system for COVID-19 hospitalisations. We defined four wave periods using incidence risk for hospitalisation, pre-wave 1, wave 1, pre-wave 2 and wave 2. We compared the characteristics of hospitalised COVID-19 cases in wave 1 and wave 2, and risk factors for in-hospital mortality accounting for wave period using multivariable logistic regression. Results: Peak rates of COVID-19 cases, admissions and in-hospital deaths in the second wave exceeded the rates in the first wave (138.1 versus 240.1; 16.7 versus 28.9; and 3.3 versus 7.1 respectively per 100,000 persons). The weekly average incidence risk increase in hospitalisation was 22% in wave 1 and 28% in wave 2 [ratio of growth rate in wave two compared to wave one: 1.04, 95% CI 1.04-1.05]. On multivariable analysis, after adjusting for weekly COVID-19 hospital admissions, there was a 20% increased risk of in-hospital mortality in the second wave (adjusted OR 1.2, 95% CI 1.2-1.3). In-hospital case fatality-risk (CFR) increased in weeks of peak hospital occupancy, from 17.9% in weeks of low occupancy (<3,500 admissions) to 29.6% in weeks of very high occupancy (>12,500 admissions) (adjusted OR 1.5, 95% CI 1.4-1.5). Compared to the first wave, individuals hospitalised in the second wave, were more likely to be older, 40-64 years [OR 1.1, 95% CI 1.0-1.1] and ≥65 years [OR 1.1, 95% CI 1.1-1.1] compared to <40 years; and admitted in the public sector [OR 2.2, 95% CI 1.7-2.8]; and less likely to have comorbidities [OR 0.5, 95% CI 0.5-0.5]. Conclusions: In South Africa, the second wave was associated with higher incidence and more rapid increase in hospitalisations, and increased in-hospital mortality. While some of this is explained by increasing pressure on the health system, a residual increase in mortality of hospitalised patients beyond this, could be related to the new lineage 501Y.V2.

show abstract

Patient Factors and Temporal Trends Associated with COVID-19 In-Hospital Mortality in England: An Observational Study Using Administrative Data

Cited by 44 publications

References 0 publications

A physician's approach and experience of managing patients with diabetes during COVID‐19

A physician's approach and experience of managing patients with diabetes during COVID‐19

Reply to: Neuroimmune interactions and COVID-19 in lung transplant recipients

Increased mortality among individuals hospitalised with COVID-19 during the second wave in South Africa

Contact Info

Product

Resources

About