Open AccessClinical outcome, risk assessment, and seasonal variation in hospitalized COVID-19 patients—Results from the CORONA Germany study
Author(s) -
Nele Geßler,
Melanie Gunawardene,
Peter Wohlmuth,
Dirk Arnold,
Jüergen Behr,
Christian Gloeckner,
Klaus Herrlinger,
Thomas Hoelting,
UlrichFrank Pape,
Ruediger Schreiber,
Axel Stang,
Claas Wesseler,
Stephan Willems,
Charlotte Arms,
Christoph U. Herborn
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0252867
Subject(s) - medicine , mortality rate , epidemiology , cohort study , odds ratio , cohort , pneumonia , prospective cohort study , severity of illness , intensive care medicine , pediatrics
Background After one year of the pandemic and hints of seasonal patterns, temporal variations of in-hospital mortality in COVID-19 are widely unknown. Additionally, heterogeneous data regarding clinical indicators predicting disease severity has been published. However, there is a need for a risk stratification model integrating the effects on disease severity and mortality to support clinical decision-making. Methods We conducted a multicenter, observational, prospective, epidemiological cohort study at 45 hospitals in Germany. Until 1 January 2021, all hospitalized SARS CoV-2 positive patients were included. A comprehensive data set was collected in a cohort of seven hospitals. The primary objective was disease severity and prediction of mild, severe, and fatal cases. Ancillary analyses included a temporal analysis of all hospitalized COVID-19 patients for the entire year 2020. Findings A total of 4704 COVID-19 patients were hospitalized with a mortality rate of 19% (890/4704). Rates of mortality, need for ventilation, pneumonia, and respiratory insufficiency showed temporal variations, whereas age had a strong influence on the course of mortality. In cohort conducting analyses, prognostic factors for fatal/severe disease were: age (odds ratio (OR) 1.704, CI:[1.221–2.377]), respiratory rate (OR 1.688, CI:[1.222–2.333]), lactate dehydrogenase (LDH) (OR 1.312, CI:[1.015–1.695]), C-reactive protein (CRP) (OR 2.132, CI:[1.533–2.965]), and creatinine values (OR 2.573, CI:[1.593–4.154]. Conclusions Age, respiratory rate, LDH, CRP, and creatinine at baseline are associated with all cause death, and need for ventilation/ICU treatment in a nationwide series of COVID 19 hospitalized patients. Especially age plays an important prognostic role. In-hospital mortality showed temporal variation during the year 2020, influenced by age. Trial registration number NCT04659187 .