Features of 16,749 hospitalised UK patients with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol

  1. AB Docherty
  2. EM Harrison
  3. CA Green
  4. H Hardwick
  5. R Pius
  6. L Norman
  7. KA Holden
  8. JM Read
  9. F Dondelinger
  10. G Carson
  11. L Merson
  12. J Lee
  13. D Plotkin
  14. L Sigfrid
  15. S Halpin
  16. C Jackson
  17. C Gamble
  18. PW Horby
  19. JS Nguyen-Van-Tam
  20. ISARIC4C Investigators
  21. J Dunning
  22. PJM Openshaw
  23. JK Baillie
  24. MG Semple
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Abstract

Objective

To characterize the clinical features of patients with severe COVID-19 in the UK.

Design

Prospective observational cohort study with rapid data gathering and near real-time analysis, using a pre-approved questionnaire adopted by the WHO.

Setting

166 UK hospitals between 6 th February and 18 th April 2020.

Participants

16,749 people with COVID-19.

Interventions

No interventions were performed, but with consent samples were taken for research purposes. Many participants were co-enrolled in other interventional studies and clinical trials.

Results

The median age was 72 years [IQR 57, 82; range 0, 104], the median duration of symptoms before admission was 4 days [IQR 1,8] and the median duration of hospital stay was 7 days [IQR 4,12]. The commonest comorbidities were chronic cardiac disease (29%), uncomplicated diabetes (19%), non-asthmatic chronic pulmonary disease (19%) and asthma (14%); 47% had no documented reported comorbidity. Increased age and comorbidities including obesity were associated with a higher probability of mortality. Distinct clusters of symptoms were found: 1. respiratory (cough, sputum, sore throat, runny nose, ear pain, wheeze, and chest pain); 2. systemic (myalgia, joint pain and fatigue); 3. enteric (abdominal pain, vomiting and diarrhoea). Overall, 49% of patients were discharged alive, 33% have died and 17% continued to receive care at date of reporting. 17% required admission to High Dependency or Intensive Care Units; of these, 31% were discharged alive, 45% died and 24% continued to receive care at the reporting date. Of those receiving mechanical ventilation, 20% were discharged alive, 53% died and 27% remained in hospital.

Conclusions

We present the largest detailed description of COVID-19 in Europe, demonstrating the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.

Trial documentation

Available at <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://isaric4c.net/protocols">https://isaric4c.net/protocols</ext-link> . Ethical approval in England and Wales (13/SC/0149), and Scotland (20/SS/0028). ISRCTN (pending).

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