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@article{Docherty:2021:10.1016/S2213-2600(21)00175-2,
author = {Docherty, AB and Mulholland, RH and Lone, NI and Cheyne, CP and De, Angelis D and Diaz-Ordaz, K and Donegan, C and Drake, TM and Dunning, J and Funk, S and García-Fiñana, M and Girvan, M and Hardwick, HE and Harrison, J and Ho, A and Hughes, DM and Keogh, RH and Kirwan, PD and Leeming, G and Nguyen, Van-Tam JS and Pius, R and Russell, CD and Spencer, RG and Tom, BD and Turtle, L and Openshaw, PJ and Baillie, JK and Harrison, EM and Semple, MG and ISARIC4C, Investigators},
doi = {10.1016/S2213-2600(21)00175-2},
journal = {The Lancet Respiratory Medicine},
pages = {773--785},
title = {Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK},
url = {http://dx.doi.org/10.1016/S2213-2600(21)00175-2},
volume = {9},
year = {2021}
}

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TY  - JOUR
AB  - BACKGROUND: Mortality rates in hospitalised patients with COVID-19 in the UK appeared to decline during the first wave of the pandemic. We aimed to quantify potential drivers of this change and identify groups of patients who remain at high risk of dying in hospital. METHODS: In this multicentre prospective observational cohort study, the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK recruited a prospective cohort of patients with COVID-19 admitted to 247 acute hospitals in England, Scotland, and Wales during the first wave of the pandemic (between March 9 and Aug 2, 2020). We included all patients aged 18 years and older with clinical signs and symptoms of COVID-19 or confirmed COVID-19 (by RT-PCR test) from assumed community-acquired infection. We did a three-way decomposition mediation analysis using natural effects models to explore associations between week of admission and in-hospital mortality, adjusting for confounders (demographics, comorbidities, and severity of illness) and quantifying potential mediators (level of respiratory support and steroid treatment). The primary outcome was weekly in-hospital mortality at 28 days, defined as the proportion of patients who had died within 28 days of admission of all patients admitted in the observed week, and it was assessed in all patients with an outcome. This study is registered with the ISRCTN Registry, ISRCTN66726260. FINDINGS: Between March 9, and Aug 2, 2020, we recruited 80 713 patients, of whom 63 972 were eligible and included in the study. Unadjusted weekly in-hospital mortality declined from 32·3% (95% CI 31·8-32·7) in March 9 to April 26, 2020, to 16·4% (15·0-17·8) in June 15 to Aug 2, 2020. Reductions in mortality were observed in all age groups, in all ethnic groups, for both sexes, and in patients with and without comorbidities. After adjustment, there was a 32% reduction in
AU  - Docherty,AB
AU  - Mulholland,RH
AU  - Lone,NI
AU  - Cheyne,CP
AU  - De,Angelis D
AU  - Diaz-Ordaz,K
AU  - Donegan,C
AU  - Drake,TM
AU  - Dunning,J
AU  - Funk,S
AU  - García-Fiñana,M
AU  - Girvan,M
AU  - Hardwick,HE
AU  - Harrison,J
AU  - Ho,A
AU  - Hughes,DM
AU  - Keogh,RH
AU  - Kirwan,PD
AU  - Leeming,G
AU  - Nguyen,Van-Tam JS
AU  - Pius,R
AU  - Russell,CD
AU  - Spencer,RG
AU  - Tom,BD
AU  - Turtle,L
AU  - Openshaw,PJ
AU  - Baillie,JK
AU  - Harrison,EM
AU  - Semple,MG
AU  - ISARIC4C,Investigators
DO  - 10.1016/S2213-2600(21)00175-2
EP  - 785
PY  - 2021///
SN  - 2213-2600
SP  - 773
TI  - Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK
T2  - The Lancet Respiratory Medicine
UR  - http://dx.doi.org/10.1016/S2213-2600(21)00175-2
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34000238
UR  - https://www.sciencedirect.com/science/article/pii/S2213260021001752?via%3Dihub
UR  - http://hdl.handle.net/10044/1/89223
VL  - 9
ER  -

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