Changes in laboratory value improvement and mortality rates over the course of the pandemic: an international retrospective cohort study of hospitalised patients infected with SARS-CoV-2
Chuan Hong
(1)
,
Harrison Zhang
(1, 2, 3)
,
Sehi L'Yi
(1)
,
Griffin Weber
(1)
,
Paul Avillach
(1)
,
Bryce Tan
(4)
,
Alba Gutiérrez-Sacristán
(1)
,
Clara-Lea Bonzel
(1)
,
Nathan Palmer
(1)
,
Alberto Malovini
(5)
,
Valentina Tibollo
(5)
,
Yuan Luo
(6)
,
Meghan Hutch
(6)
,
Molei Liu
(7)
,
Florence Bourgeois
(1)
,
Riccardo Bellazzi
(8, 5)
,
Luca Chiovato
(8)
,
Fernando Sanz Vidorreta
(9)
,
Trang Le
(10)
,
Xuan Wang
(1)
,
William Yuan
(1)
,
Antoine Neuraz
(11, 12, 13)
,
Vincent Benoit
(14)
,
Bertrand Moal
(15)
,
Michele Morris
(16)
,
David Hanauer
(17)
,
Sarah Maidlow
(18)
,
Kavishwar Wagholikar
(19)
,
Shawn Murphy
(19)
,
Hossein Estiri
(19)
,
Adeline Makoudjou
(20)
,
Patric Tippmann
(20)
,
Jeffery Klann
(19)
,
Robert Follett
(9)
,
Nils Gehlenborg
(1)
,
Gilbert Omenn
(18)
,
Zongqi Xia
(16)
,
Arianna Dagliati
(8)
,
Shyam Visweswaran
(16)
,
Lav Patel
(21)
,
Danielle Mowery
(22)
,
Emily Schriver
(22)
,
Malarkodi Jebathilagam Samayamuthu
(16)
,
Ramakanth Kavuluru
(23)
,
Sara Lozano-Zahonero
(20)
,
Daniela Zöller
(20)
,
Amelia Tan
(1)
,
Byorn Tan
(4)
,
Kee Yuan Ngiam
(4)
,
John Holmes
(10)
,
Petra Schubert
(24)
,
Kelly Cho
(24)
,
Yuk-Lam Ho
(24)
,
Brett Beaulieu-Jones
(1)
,
Miguel Pedrera Jiménez
(25)
,
Noelia García-Barrio
(25)
,
Pablo Serrano-Balazote
(25)
,
Tianxi Cai
(1)
,
Isaac Kohane
(1)
,
Andrew South
(26)
,
Gabriel Brat
(1)
1
HMS -
Harvard Medical School [Boston]
2 BWH - Brigham & Women’s Hospital [Boston]
3 Columbia University [New York]
4 NUH - National University Hospital [Singapore]
5 IRCCS Pavia - ICS Maugeri - Istituti Clinici Scientifici Maugeri [Pavia]
6 Northwestern University [Evanston]
7 Harvard T.H. Chan School of Public Health
8 UNIPV - Università degli Studi di Pavia [Italia] = University of Pavia [Italy] = Université de Pavie [Italie]
9 David Geffen School of Medicine [Los Angeles]
10 University of Pennsylvania
11 UPCité - Université Paris Cité
12 HeKA - Health data- and model- driven Knowledge Acquisition
13 Service d'informatique médicale et biostatistiques [CHU Necker]
14 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
15 UB - Université de Bordeaux
16 PITT - University of Pittsburgh
17 University of Michigan Medical School [Ann Arbor]
18 University of Michigan [Ann Arbor]
19 Massachusetts General Hospital [Boston]
20 Albert-Ludwigs-Universität Freiburg = University of Freiburg
21 University of Kansas [Kansas City]
22 HUP - Hospital of the University of Pennsylvania
23 UK - University of Kentucky
24 VA Boston Healthcare System
25 Hospital Universitario 12 de Octubre [Madrid]
26 Wake Forest University
2 BWH - Brigham & Women’s Hospital [Boston]
3 Columbia University [New York]
4 NUH - National University Hospital [Singapore]
5 IRCCS Pavia - ICS Maugeri - Istituti Clinici Scientifici Maugeri [Pavia]
6 Northwestern University [Evanston]
7 Harvard T.H. Chan School of Public Health
8 UNIPV - Università degli Studi di Pavia [Italia] = University of Pavia [Italy] = Université de Pavie [Italie]
9 David Geffen School of Medicine [Los Angeles]
10 University of Pennsylvania
11 UPCité - Université Paris Cité
12 HeKA - Health data- and model- driven Knowledge Acquisition
13 Service d'informatique médicale et biostatistiques [CHU Necker]
14 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
15 UB - Université de Bordeaux
16 PITT - University of Pittsburgh
17 University of Michigan Medical School [Ann Arbor]
18 University of Michigan [Ann Arbor]
19 Massachusetts General Hospital [Boston]
20 Albert-Ludwigs-Universität Freiburg = University of Freiburg
21 University of Kansas [Kansas City]
22 HUP - Hospital of the University of Pennsylvania
23 UK - University of Kentucky
24 VA Boston Healthcare System
25 Hospital Universitario 12 de Octubre [Madrid]
26 Wake Forest University
Chuan Hong
- Fonction : Auteur
- PersonId : 792801
- ORCID : 0000-0001-7056-9559
Griffin Weber
- Fonction : Auteur
- PersonId : 818086
- ORCID : 0000-0002-2597-881X
Fernando Sanz Vidorreta
- Fonction : Auteur
- PersonId : 818099
- ORCID : 0000-0001-7165-0949
Antoine Neuraz
- Fonction : Auteur
- PersonId : 1122536
- IdHAL : antoine-neuraz
Patric Tippmann
- Fonction : Auteur
- PersonId : 1198790
- ORCID : 0000-0001-6521-8607
Lav Patel
- Fonction : Auteur
- PersonId : 818063
- ORCID : 0000-0002-8626-137X
Malarkodi Jebathilagam Samayamuthu
- Fonction : Auteur
- PersonId : 818098
- ORCID : 0000-0003-0061-8196
Kee Yuan Ngiam
- Fonction : Auteur
- PersonId : 802111
- ORCID : 0000-0001-5676-2520
Petra Schubert
- Fonction : Auteur
- PersonId : 818091
- ORCID : 0000-0002-6135-0173
Miguel Pedrera Jiménez
- Fonction : Auteur
- PersonId : 818097
- ORCID : 0000-0003-0187-3826
Résumé
Objective To assess changes in international mortality rates and laboratory recovery rates during hospitalisation for patients hospitalised with SARS-CoV-2 between the first wave (1 March to 30 June 2020) and the second wave (1 July 2020 to 31 January 2021) of the COVID-19 pandemic. Design, setting and participants This is a retrospective cohort study of 83 178 hospitalised patients admitted between 7 days before or 14 days after PCR-confirmed SARS-CoV-2 infection within the Consortium for Clinical Characterization of COVID-19 by Electronic Health Record, an international multihealthcare system collaborative of 288 hospitals in the USA and Europe. The laboratory recovery rates and mortality rates over time were compared between the two waves of the pandemic. Primary and secondary outcome measures The primary outcome was all-cause mortality rate within 28 days after hospitalisation stratified by predicted low, medium and high mortality risk at baseline. The secondary outcome was the average rate of change in laboratory values during the first week of hospitalisation. Results Baseline Charlson Comorbidity Index and laboratory values at admission were not significantly different between the first and second waves. The improvement in laboratory values over time was faster in the second wave compared with the first. The average C reactive protein rate of change was –4.72 mg/dL vs –4.14 mg/dL per day (p=0.05). The mortality rates within each risk category significantly decreased over time, with the most substantial decrease in the high-risk group (42.3% in March–April 2020 vs 30.8% in November 2020 to January 2021, p<0.001) and a moderate decrease in the intermediate-risk group (21.5% in March–April 2020 vs 14.3% in November 2020 to January 2021, p<0.001). Conclusions Admission profiles of patients hospitalised with SARS-CoV-2 infection did not differ greatly between the first and second waves of the pandemic, but there were notable differences in laboratory improvement rates during hospitalisation. Mortality risks among patients with similar risk profiles decreased over the course of the pandemic. The improvement in laboratory values and mortality risk was consistent across multiple countries.