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 Murthy, Srinivas
A1 Archambault, Patrick M.
A1 Atique, Anika
A1 Carrier, François Martin
A1 Cheng, Matthew P.
A1 Codan, Cassidy
A1 Daneman, Nick
A1 Dechert, William
A1 Douglas, Sarah
A1 Fiest, Kirsten M.
A1 Fowler, Robert
A1 Goco, Geraldine
A1 Gu, Yusing
A1 Guerguerian, Anne-Marie
A1 Hall, Richard
A1 Hsu, Jimmy M.
A1 Joffe, Ari
A1 Jouvet, Philippe
A1 Kelly, Laurel
A1 Kho, Michelle E.
A1 Kruisselbrink, Rebecca J.
A1 Kumar, Deepali
A1 Kutsogiannis, Demetrios James
A1 Lamontagne, François
A1 Lee, Todd C.
A1 Menon, Kusum
A1 O’Grady, Heather
A1 O’Hearn, Katie
A1 Ovakim, Daniel H.
A1 Pharand, Scott G.
A1 Pitre, Tyler
A1 Reel, Riley
A1 Reeve, Brenda
A1 Rewa, Oleksa
A1 Richardson, David
A1 Rishu, Asgar
A1 Sandhu, Gyan
A1 Sarfo-Mensah, Shirley
A1 Shadowitz, Ellen
A1 Sligl, Wendy
A1 Solomon, Joshua
A1 Stelfox, Henry T.
A1 Swanson, Ashleigh
A1 Tessier-Grenier, Hubert
A1 Tsang, Jennifer L.Y.
A1 Wood, Gordon
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.