Trends in characteristics and outcomes among US adults hospitalised with COVID-19 throughout 2020: an observational cohort study

Abstract

ObjectivesTo examine the temporal patterns of patient characteristics, treatments used and outcomes associated with COVID-19 in patients who were hospitalised for the disease between January and 15 November 2020.DesignObservational cohort study.SettingCOVID-19 subset of the Optum deidentified electronic health records, including more than 1.8 million patients from across the USA.ParticipantsThere were 51 510 hospitalised patients who met the COVID-19 definition, with 37 617 in the laboratory positive cohort and 13 893 in the clinical cohort.Primary and secondary outcome measuresIncident acute clinical outcomes, including in-hospital all-cause mortality.ResultsRespectively, 48% and 49% of the laboratory positive and clinical cohorts were women. The 50– 65 age group was the median age group for both cohorts. The use of antivirals and dexamethasone increased over time, fivefold and twofold, respectively, while the use of hydroxychloroquine declined by 98%. Among adult patients in the laboratory positive cohort, absolute age/sex standardised incidence proportion for in-hospital death changed by −0.036 per month (95% CI −0.042 to –0.031) from March to June 2020, but remained fairly flat from June to November, 2020 (0.001 (95% CI −0.001 to 0.003), 17.5% (660 deaths /3986 persons) in March and 10.2% (580/5137) in October); in the clinical cohort, the corresponding changes were −0.024 (95% CI −0.032 to –0.015) and 0.011 (95% CI 0.007 0.014), respectively (14.8% (175/1252) in March, 15.3% (189/1203) in October). Declines in the cumulative incidence of most acute clinical outcomes were observed in the laboratory positive cohort, but not for the clinical cohort.ConclusionThe incidence of adverse clinical outcomes remains high among COVID-19 patients with clinical diagnosis only. Patients with COVID-19 entering the hospital are at elevated risk of adverse outcomes.

Combining L-Arginine with vitamin C improves long-COVID symptoms: The LINCOLN Survey

“…The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has led to a global healthcare crisis [1] . The global pandemic has resulted also in job losses and economic hardships [2] .…”

Real-World Effectiveness of Nirmatrelvir/Ritonavir in Preventing Hospitalization Among Patients With COVID-19 at High Risk for Severe Disease in the United States: A Nationwide Population-Based Cohort Study

“…4 This is encouraging given the SARS-CoV-2 epidemiologic landscape differed between the 2 studies in that EPIC-HR was conducted during the Delta wave whereas the current study was conducted during Omicron predominance. In contrast to EPIC-HR, this real-world study did not use a composite effectiveness endpoint that included death because the exact day of death was not captured in the EHR database (only month of death was available 13 ). Therefore, accurate characterization of nirmatrelvir/ritonavir effectiveness against mortality was not possible.…”

“…As of June 8, 2022, which includes the Omicron-predominant period, the COVID-19 database included ∼12 million individuals, derived from Optum’s EHR repository with >700 hospitals and 7000 clinics from all US states. 13…”

Changing trends of patient characteristics and treatment pathways during the COVID-19 pandemic: A cross-sectional analysis of 72,459 inpatient cases from the German Helios database

“…Reports extending their period of interest to the upstroke of the second pandemic wave showed similar results. Patients being hospitalized after the first wave were younger, had less comorbidities and a milder disease presentation leading to a reduced short-term mortality even after the adjustment for covariates ( 7 , 12 , 28 ). However, the evolution of mortality rates was not uniform in between different investigations.…”