The first 20 months of the COVID-19 pandemic: Mortality, intubation and ICU rates among 104,590 pati...
The first 20 months of the COVID-19 pandemic: Mortality, intubation and ICU rates among 104,590 patients hospitalized at 21 United States health systems
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Author / Creator
Michael C Fiore , Stevens S Smith , Robert T Adsit , Daniel M Bolt , Karen L Conner , Steven L Bernstein , Oliver D Eng , David Lazuk , Alec Gonzalez , Douglas E Jorenby , Heather D'Angelo , Julie A Kirsch , Brian Williams , Margaret B Nolan , Todd Hayes-Birchler , Sean Kent , Hanna Kim , Thomas M Piasecki , Wendy S Slutske , Stan Lubanski , Menggang Yu , Youmi Suk , Yuxin Cai , Nitu Kashyap , Jomol P Mathew , Gabriel McMahan , Betsy Rolland , Hilary A Tindle , Graham W Warren , Lawrence C An , Andrew D Boyd , Darlene H Brunzell , Victor Carrillo , Li-Shiun Chen , James M Davis , Deepika Dilip , Edward F Ellerbeck , Eduardo Iturrate , Thulasee Jose , Niharika Khanna , Andrea King , Elizabeth Klass , Michael Newman , Kimberly A Shoenbill , Elisa Tong , Janice Y Tsoh , Karen M Wilson , Wendy E Theobald and Timothy B Baker
Publisher
Public Library of Science (PLoS)
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Language
English
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Publisher
Public Library of Science (PLoS)
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Scope and Contents
Contents
Main objectiveThere is limited information on how patient outcomes have changed during the COVID-19 pandemic. This study characterizes changes in mortality, intubation, and ICU admission rates during the first 20 months of the pandemic.Study design and methodsUniversity of Wisconsin researchers collected and harmonized electronic health record data from 1.1 million COVID-19 patients across 21 United States health systems from February 2020 through September 2021. The analysis comprised data from 104,590 adult hospitalized COVID-19 patients. Inclusion criteria for the analysis were: (1) age 18 years or older; (2) COVID-19 ICD-10 diagnosis during hospitalization and/or a positive COVID-19 PCR test in a 14-day window (+/- 7 days of hospital admission); and (3) health system contact prior to COVID-19 hospitalization. Outcomes assessed were: (1) mortality (primary), (2) endotracheal intubation, and (3) ICU admission.Results and significanceThe 104,590 hospitalized participants had a mean age of 61.7 years and were 50.4% female, 24% Black, and 56.8% White. Overall risk-standardized mortality (adjusted for age, sex, race, ethnicity, body mass index, insurance status and medical comorbidities) declined from 16% of hospitalized COVID-19 patients (95% CI: 16% to 17%) early in the pandemic (February-April 2020) to 9% (CI: 9% to 10%) later (July-September 2021). Among subpopulations, males (vs. females), those on Medicare (vs. those on commercial insurance), the severely obese (vs. normal weight), and those aged 60 and older (vs. younger individuals) had especially high mortality rates both early and late in the pandemic. ICU admission and intubation rates also declined across these 20 months.ConclusionsMortality, intubation, and ICU admission rates improved markedly over the first 20 months of the pandemic among adult hospitalized COVID-19 patients although gains varied by subpopulation. These data provide important information on the course of COVID-19 and identify hospitalized patient groups at heightened risk for negative outcomes.Trial registrationClinicalTrials.gov Identifier: NCT04506528 (https://clinicaltrials.gov/ct2/show/NCT04506528)....
Alternative Titles
Full title
The first 20 months of the COVID-19 pandemic: Mortality, intubation and ICU rates among 104,590 patients hospitalized at 21 United States health systems
Authors, Artists and Contributors
Author / Creator
Stevens S Smith
Robert T Adsit
Daniel M Bolt
Karen L Conner
Steven L Bernstein
Oliver D Eng
David Lazuk
Alec Gonzalez
Douglas E Jorenby
Heather D'Angelo
Julie A Kirsch
Brian Williams
Margaret B Nolan
Todd Hayes-Birchler
Sean Kent
Hanna Kim
Thomas M Piasecki
Wendy S Slutske
Stan Lubanski
Menggang Yu
Youmi Suk
Yuxin Cai
Nitu Kashyap
Jomol P Mathew
Gabriel McMahan
Betsy Rolland
Hilary A Tindle
Graham W Warren
Lawrence C An
Andrew D Boyd
Darlene H Brunzell
Victor Carrillo
Li-Shiun Chen
James M Davis
Deepika Dilip
Edward F Ellerbeck
Eduardo Iturrate
Thulasee Jose
Niharika Khanna
Andrea King
Elizabeth Klass
Michael Newman
Kimberly A Shoenbill
Elisa Tong
Janice Y Tsoh
Karen M Wilson
Wendy E Theobald
Timothy B Baker
Identifiers
Primary Identifiers
Record Identifier
TN_cdi_doaj_primary_oai_doaj_org_article_f04f7458f5a34700b43c44ba4f5d21c3
Permalink
https://devfeature-collection.sl.nsw.gov.au/record/TN_cdi_doaj_primary_oai_doaj_org_article_f04f7458f5a34700b43c44ba4f5d21c3
Other Identifiers
E-ISSN
1932-6203
DOI
10.1371/journal.pone.0274571