RT Journal Article
SR Electronic
T1 Characteristics and outcomes of patients with COVID-19 admitted to hospital and intensive care in the first phase of the pandemic in Canada: a national cohort study
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E181
OP E188
DO 10.9778/cmajo.20200250
VO 9
IS 1
A1 Srinivas Murthy
A1 Patrick M. Archambault
A1 Anika Atique
A1 François Martin Carrier
A1 Matthew P. Cheng
A1 Cassidy Codan
A1 Nick Daneman
A1 William Dechert
A1 Sarah Douglas
A1 Kirsten M. Fiest
A1 Robert Fowler
A1 Geraldine Goco
A1 Yusing Gu
A1 Anne-Marie Guerguerian
A1 Richard Hall
A1 Jimmy M. Hsu
A1 Ari Joffe
A1 Philippe Jouvet
A1 Laurel Kelly
A1 Michelle E. Kho
A1 Rebecca J. Kruisselbrink
A1 Deepali Kumar
A1 Demetrios James Kutsogiannis
A1 François Lamontagne
A1 Todd C. Lee
A1 Kusum Menon
A1 Heather O’Grady
A1 Katie O’Hearn
A1 Daniel H. Ovakim
A1 Scott G. Pharand
A1 Tyler Pitre
A1 Riley Reel
A1 Brenda Reeve
A1 Oleksa Rewa
A1 David Richardson
A1 Asgar Rishu
A1 Gyan Sandhu
A1 Shirley Sarfo-Mensah
A1 Ellen Shadowitz
A1 Wendy Sligl
A1 Joshua Solomon
A1 Henry T. Stelfox
A1 Ashleigh Swanson
A1 Hubert Tessier-Grenier
A1 Jennifer L.Y. Tsang
A1 Gordon Wood
A1 ,
YR 2021
UL http://www.cmajopen.ca/content/9/1/E181.abstract
AB Background: Clinical data on patients admitted to hospital with coronavirus disease 2019 (COVID-19) provide clinicians and public health officials with information to guide practice and policy. The aims of this study were to describe patients with COVID-19 admitted to hospital and intensive care, and to investigate predictors of outcome to characterize severe acute respiratory infection.Methods: This observational cohort study used Canadian data from 32 selected hospitals included in a global multisite cohort between Jan. 24 and July 7, 2020. Adult and pediatric patients with a confirmed diagnosis of COVID-19 who received care in an intensive care unit (ICU) and a sampling of up to the first 60 patients receiving care on hospital wards were included. We performed descriptive analyses of characteristics, interventions and outcomes. The primary analyses examined in-hospital mortality, with secondary analyses of the length of hospital and ICU stay.Results: Between January and July 2020, among 811 patients admitted to hospital with a diagnosis of COVID-19, the median age was 64 (interquartile range [IQR] 53–75) years, 495 (61.0%) were men, 46 (5.7%) were health care workers, 9 (1.1%) were pregnant, 26 (3.2%) were younger than 18 years and 9 (1.1%) were younger than 5 years. The median time from symptom onset to hospital admission was 7 (IQR 3–10) days. The most common symptoms on admission were fever, shortness of breath, cough and malaise. Diabetes, hypertension and cardiac, kidney and respiratory disease were the most common comorbidities. Among all patients, 328 received care in an ICU, admitted a median of 0 (IQR 0–1) days after hospital admission. Critically ill patients received treatment with invasive mechanical ventilation (88.8%), renal replacement therapy (14.9%) and extracorporeal membrane oxygenation (4.0%); 26.2% died. Among those receiving mechanical ventilation, 31.2% died. Age was an influential predictor of mortality (odds ratio per additional year of life 1.06, 95% confidence interval 1.03–1.09).Interpretation: Patients admitted to hospital with COVID-19 commonly had fever, respiratory symptoms and comorbid conditions. Increasing age was associated with the development of critical illness and death; however, most critically ill patients in Canada, including those requiring mechanical ventilation, survived and were discharged from hospital.