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
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 a...
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2022-06-01
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| author | Ramakanth Kavuluru Xuan Wang Paul Avillach Florence Bourgeois Kee Yuan Ngiam Gabriel A Brat Isaac Kohane Tianxi Cai Yuk-Lam Ho Yuan Luo Harrison G Zhang Kelly Cho Vincent Benoit Antoine Neuraz Chuan Hong Sehi L'Yi Griffin Weber Bryce W Q Tan Alba Gutiérrez-Sacristán Clara-Lea Bonzel Nathan P Palmer Alberto Malovini Valentina Tibollo Meghan R Hutch Molei Liu Riccardo Bellazzi Luca Chiovato Fernando J Sanz Vidorreta Trang T Le William Yuan Bertrand Moal Michele Morris David A Hanauer Sarah Maidlow Kavishwar Wagholikar Shawn Murphy Hossein Estiri Adeline Makoudjou Patric Tippmann Jeffery Klann Robert W Follett Nils Gehlenborg Gilbert S Omenn Zongqi Xia Arianna Dagliati Shyam Visweswaran Lav P Patel Danielle L Mowery Emily R Schriver Malarkodi Jebathilagam Samayamuthu Sara Lozano-Zahonero Daniela Zöller Amelia L M Tan Byorn W L Tan John H Holmes Petra Schubert Brett K. Beaulieu-Jones Miguel Pedrera-Jiménez Noelia García-Barrio Pablo Serrano-Balazote Andrew South |
| author_facet | Ramakanth Kavuluru Xuan Wang Paul Avillach Florence Bourgeois Kee Yuan Ngiam Gabriel A Brat Isaac Kohane Tianxi Cai Yuk-Lam Ho Yuan Luo Harrison G Zhang Kelly Cho Vincent Benoit Antoine Neuraz Chuan Hong Sehi L'Yi Griffin Weber Bryce W Q Tan Alba Gutiérrez-Sacristán Clara-Lea Bonzel Nathan P Palmer Alberto Malovini Valentina Tibollo Meghan R Hutch Molei Liu Riccardo Bellazzi Luca Chiovato Fernando J Sanz Vidorreta Trang T Le William Yuan Bertrand Moal Michele Morris David A Hanauer Sarah Maidlow Kavishwar Wagholikar Shawn Murphy Hossein Estiri Adeline Makoudjou Patric Tippmann Jeffery Klann Robert W Follett Nils Gehlenborg Gilbert S Omenn Zongqi Xia Arianna Dagliati Shyam Visweswaran Lav P Patel Danielle L Mowery Emily R Schriver Malarkodi Jebathilagam Samayamuthu Sara Lozano-Zahonero Daniela Zöller Amelia L M Tan Byorn W L Tan John H Holmes Petra Schubert Brett K. Beaulieu-Jones Miguel Pedrera-Jiménez Noelia García-Barrio Pablo Serrano-Balazote Andrew South |
| collection | DOAJ |
| description | 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 (47.1% 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. |
| format | Article |
| id | doaj-art-e2282eaf7d9e4b11a965e40656afafd1 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-e2282eaf7d9e4b11a965e40656afafd12025-01-28T06:05:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057725Changes 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 0Ramakanth Kavuluru1Xuan Wang2Paul Avillach3Florence Bourgeois4Kee Yuan Ngiam5Gabriel A Brat6Isaac Kohane7Tianxi Cai8Yuk-Lam Ho9Yuan Luo10Harrison G Zhang11Kelly Cho12Vincent Benoit13Antoine Neuraz14Chuan Hong15Sehi L'Yi16Griffin Weber17Bryce W Q Tan18Alba Gutiérrez-Sacristán19Clara-Lea Bonzel20Nathan P Palmer21Alberto Malovini22Valentina Tibollo23Meghan R Hutch24Molei Liu25Riccardo Bellazzi26Luca Chiovato27Fernando J Sanz Vidorreta28Trang T Le29William Yuan30Bertrand Moal31Michele Morris32David A Hanauer33Sarah Maidlow34Kavishwar Wagholikar35Shawn Murphy36Hossein Estiri37Adeline Makoudjou38Patric Tippmann39Jeffery Klann40Robert W Follett41Nils Gehlenborg42Gilbert S Omenn43Zongqi Xia44Arianna Dagliati45Shyam Visweswaran46Lav P Patel47Danielle L Mowery48Emily R Schriver49Malarkodi Jebathilagam Samayamuthu50Sara Lozano-Zahonero51Daniela Zöller52Amelia L M Tan53Byorn W L Tan54John H Holmes55Petra Schubert56Brett K. Beaulieu-Jones57Miguel Pedrera-Jiménez58Noelia García-Barrio59Pablo Serrano-Balazote60Andrew South61UK Heat Illness Advisory Group, London, UKInstitute for Biomedical Informatics, University of Kentucky, Lexington, Kentucky, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USAAarhus University, Aarhus, Denmark2 Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USAYong Loo Lin School of Medicine, National University of Singapore, Singapore1 Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USAMassachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, USADepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USAMillion Veteran Program (MVP) Coordinating Center, Veterans Affairs Healthcare System, Boston, Massachusetts, USAIT department, Innovation & Data, APHP Greater Paris University Hospital, Paris, FranceBiostatistics, Imagine Institute, AP*HP, Necker Hospital, Paris, FranceDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Medicine, National University Hospital, SingaporeDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USALaboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Lombardia, ItalyLaboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Lombardia, ItalyDepartment of Preventive Medicine, Northwestern University, Evanston, Illinois, USADepartment of Biostatistics, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USADepartment of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, ItalyUnit of Internal Medicine and Endocrinology, Istituti Clinici Scientifici Maugeri SpA SB IRCCS, Pavia, Lombardia, ItalyDepartment of Medicine, David Geffen School of Medicine, Los Angeles, California, USADepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USAIAM unit, Bordeaux University Hospital, Bordeaux, FranceDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USAMICHR Informatics, University of Michigan, Ann Arbor, Michigan, USADepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USANeurology, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USAInstitute of Medical Biometry and Statistics, University of Freiburg Faculty of Medicine, Freiburg, Baden-Württemberg, GermanyInstitute of Medical Biometry and Statistics, Medical Center-University of Freiburg, Freiburg, Baden-Württemberg, GermanyDepartment of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USADepartment of Medicine, David Geffen School of Medicine, Los Angeles, California, USADepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USAComputational Medicine & Bioinformatics, University of Michigan, Ann Arbor, Michigan, USADepartment of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USADepartment of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, ItalyDepartment of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Kansas, USADepartment of Internal Medicine, Division of Medical Informatics, University of Kansas Medical Center, Kansas City, Kansas, USADepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAData Analytics Center, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USABiomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USAInstitute of Medical Biometry and Statistics, University of Freiburg Faculty of Medicine, Freiburg, Baden-Württemberg, GermanyInstitute of Medical Biometry and Statistics, University of Freiburg Faculty of Medicine, Freiburg, Baden-Württemberg, GermanyDepartment of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USADepartment of Medicine, National University Hospital, SingaporeDepartment of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAMassachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, USABiomedical Informatics, Harvard Medical School, Boston, Massachusetts, USAHealth Informatics, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, SpainHealth Informatics, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, SpainHealth Informatics, Hospital Universitario 12 de Octubre, Madrid, Comunidad de Madrid, SpainDepartment of Pediatrics, Section of Nephrology, Wake Forest University, Winston Salem, North Carolina, USAObjective 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 (47.1% 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.https://bmjopen.bmj.com/content/12/6/e057725.full |
| spellingShingle | Ramakanth Kavuluru Xuan Wang Paul Avillach Florence Bourgeois Kee Yuan Ngiam Gabriel A Brat Isaac Kohane Tianxi Cai Yuk-Lam Ho Yuan Luo Harrison G Zhang Kelly Cho Vincent Benoit Antoine Neuraz Chuan Hong Sehi L'Yi Griffin Weber Bryce W Q Tan Alba Gutiérrez-Sacristán Clara-Lea Bonzel Nathan P Palmer Alberto Malovini Valentina Tibollo Meghan R Hutch Molei Liu Riccardo Bellazzi Luca Chiovato Fernando J Sanz Vidorreta Trang T Le William Yuan Bertrand Moal Michele Morris David A Hanauer Sarah Maidlow Kavishwar Wagholikar Shawn Murphy Hossein Estiri Adeline Makoudjou Patric Tippmann Jeffery Klann Robert W Follett Nils Gehlenborg Gilbert S Omenn Zongqi Xia Arianna Dagliati Shyam Visweswaran Lav P Patel Danielle L Mowery Emily R Schriver Malarkodi Jebathilagam Samayamuthu Sara Lozano-Zahonero Daniela Zöller Amelia L M Tan Byorn W L Tan John H Holmes Petra Schubert Brett K. Beaulieu-Jones Miguel Pedrera-Jiménez Noelia García-Barrio Pablo Serrano-Balazote Andrew South 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 BMJ Open |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | https://bmjopen.bmj.com/content/12/6/e057725.full |
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