COVID-19 Management in a UK NHS Foundation Trust with a High Consequence Infectious Diseases Centre: A Retrospective Analysis
Recent large national and international cohorts describe the baseline characteristics and outcome of hospitalised patients with COVID-19, however there is limited granularity to these reports. We aimed to provide a detailed description of a UK COVID-19 cohort, focusing on management and outcome. We...
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Published in | Medical sciences (Basel) Vol. 9; no. 1; p. 6 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Switzerland
MDPI AG
04.02.2021
MDPI |
Subjects | |
Online Access | Get full text |
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Summary: | Recent large national and international cohorts describe the baseline characteristics and outcome of hospitalised patients with COVID-19, however there is limited granularity to these reports. We aimed to provide a detailed description of a UK COVID-19 cohort, focusing on management and outcome. We performed a retrospective single-centre analysis of clinical management and 28-day outcomes of consecutive adult inpatients with SARS-CoV-2 PCR-confirmed COVID-19 from 31 January to 16 April 2020 inclusive. In total, 316 cases were identified. Most patients were elderly (median age 75) with multiple comorbidities. One quarter were admitted from residential or nursing care. Mortality was 84 out of 316 (26.6%). Most deaths occurred in patients in whom a ceiling of inpatient treatment had been determined and for whom end of life care and specialist palliative care input was provided where appropriate. No deaths occurred in patients aged under 56 years. Decisions to initiate respiratory support were individualised after consideration of patient wishes, premorbid frailty and comorbidities. In total, 59 (18%) patients were admitted to intensive care, of which 31 (10% overall cohort) required intubation. Multiple logistic regression identified associations between death and age, frailty, and disease severity, with age as the most significant factor (odds ratio 1.07 [95% CI 1.03-1.10] per year increase,
< 0.001). These findings provide important clinical context to outcome data. Mortality was associated with increasing age. Most deaths were anticipated and occurred in patients with advance decisions on ceilings of treatment. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 NUTH COVID Control Group: Margaret Gray, Derna Campbell, Michael Clark, Angela Cobb, Sue Cook, Melanie Cunningham, Lewis Gibson, Lisa Guthrie, Elizabeth Harris, David Kinnersley, Allison Sykes, Michael Wright. NUTH COVID Clinical Group: Kevin Brennan, Graham Burns, Matthew Cadamy, Ian Clement, Jennifer Collins, Jill Dixon, Martin Duddy, Adam Evans, Simon Hill, Kelly Hunt, Simon Kerr, Stuart Little, Christopher Mountford, Anne Pelham, Sarah Platt, Ulrich Schwab, Julie Samuel, Ally Speight, Nadia Stock, Jason Urron, Jon Walton, Sophie West. |
ISSN: | 2076-3271 2076-3271 |
DOI: | 10.3390/medsci9010006 |