Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol



Docherty, AB, Harrison, EM, Green, CA, Hardwick, H, Pius, R, Norman, L, Holden, KA, Read, JM, Dondelinger, F ORCID: 0000-0003-1816-6300, Carson, G ORCID: 0000-0001-8439-9933
et al (show 14 more authors) (2020) Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol.

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Abstract

<h4>Structured abstract</h4> <h4>Objective</h4> To characterize the clinical features of patients with severe COVID-19 in the UK. <h4>Design</h4> Prospective observational cohort study with rapid data gathering and near real-time analysis, using a pre-approved questionnaire adopted by the WHO. <h4>Setting</h4> 166 UK hospitals between 6 th February and 18 th April 2020. <h4>Participants</h4> 16,749 people with COVID-19. <h4>Interventions</h4> No interventions were performed, but with consent samples were taken for research purposes. Many participants were co-enrolled in other interventional studies and clinical trials. <h4>Results</h4> The median age was 72 years [IQR 57, 82; range 0, 104], the median duration of symptoms before admission was 4 days [IQR 1,8] and the median duration of hospital stay was 7 days [IQR 4,12]. The commonest comorbidities were chronic cardiac disease (29%), uncomplicated diabetes (19%), non-asthmatic chronic pulmonary disease (19%) and asthma (14%); 47% had no documented reported comorbidity. Increased age and comorbidities including obesity were associated with a higher probability of mortality. Distinct clusters of symptoms were found: 1. respiratory (cough, sputum, sore throat, runny nose, ear pain, wheeze, and chest pain); 2. systemic (myalgia, joint pain and fatigue); 3. enteric (abdominal pain, vomiting and diarrhoea). Overall, 49% of patients were discharged alive, 33% have died and 17% continued to receive care at date of reporting. 17% required admission to High Dependency or Intensive Care Units; of these, 31% were discharged alive, 45% died and 24% continued to receive care at the reporting date. Of those receiving mechanical ventilation, 20% were discharged alive, 53% died and 27% remained in hospital. <h4>Conclusions</h4> We present the largest detailed description of COVID-19 in Europe, demonstrating the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks. <h4>Trial documentation</h4> Available at https://isaric4c.net/protocols . Ethical approval in England and Wales (13/SC/0149), and Scotland (20/SS/0028). ISRCTN (pending).

Item Type: Article
Uncontrolled Keywords: ISARIC4C Investigators
Depositing User: Symplectic Admin
Date Deposited: 24 Jun 2020 10:47
Last Modified: 14 Jan 2021 06:12
DOI: 10.1101/2020.04.23.20076042
Open Access URL: http://oi.org/10.1101/2020.05.21.20105486
URI: https://livrepository.liverpool.ac.uk/id/eprint/3090726