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Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020.

ABSTRACT: BackgroundIn March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization.AimOur objective was to identify risk factors predictive of severe disease and death in France.MethodsIn this prospective cohort study, we included patients???18?years old with confirmed COVID-19, hospitalised in Strasbourg and Mulhouse hospitals (France), in March 2020. We respectively compared patients who developed severe disease (admission to an intensive care unit (ICU) or death) and patients who died, to those who did not, by day?7 after hospitalisation.ResultsAmong 1,045 patients, 424 (41%) had severe disease, including 335 (32%) who were admitted to ICU, and 115 (11%) who died. Mean age was 66?years (range:?20-100), and 612 (59%) were men. Almost 75% of patients with body mass index (BMI) data (n?=?897) had a BMI???25?kg/m2 (n?=?661). Independent risk factors associated with severe disease were advanced age (odds ratio (OR):?1.1 per?10-year increase; 95%?CrI (credible interval):?1.0-1.2), male sex (OR:?2.1;?95%?CrI:?1.5-2.8), BMI of 25-29.9?kg/m2 (OR:?1.8;?95%?CrI:?1.2-2.7) or???30 (OR:?2.2;?95%?CrI:?1.5-3.3), dyspnoea (OR:?2.5;?95%?CrI:?1.8-3.4) and inflammatory parameters (elevated C-reactive protein and neutrophil count, low lymphocyte count). Risk factors associated with death were advanced age (OR:?2.7 per?10-year increase;?95%?CrI:?2.1-3.4), male sex (OR:?1.7;?95%?CrI:?1.1-2.7), immunosuppression (OR:?3.8;?95%?CrI:?1.6-7.7), diabetes (OR:?1.7;?95%?CrI:?1.0-2.7), chronic kidney disease (OR:?2.3;?95%?CrI:?1.3-3.9), dyspnoea (OR:?2.1;?95%?CrI:?1.2-3.4) and inflammatory parameters.ConclusionsOverweightedness, obesity, advanced age, male sex, comorbidities, dyspnoea and inflammation are risk factors for severe COVID-19 or death in hospitalised patients. Identifying these features among patients in routine clinical practice might improve COVID-19 management.

SUBMITTER: Kaeuffer C

PROVIDER: S-EPMC7716399 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020.

Kaeuffer Charlotte C Le Hyaric Coralie C Fabacher Thibaut T Mootien Joy J Dervieux Benjamin B Ruch Yvon Y Hugerot Antonin A Zhu Yves-Jean YJ Pointurier Valentin V Clere-Jehl Raphael R Greigert Valentin V Kassegne Loic L Lefebvre Nicolas N Gallais Floriane F Meyer Nicolas N Hansmann Yves Y Hinschberger Olivier O Danion François F

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 20201201 48

BackgroundIn March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization.AimOur objective was to identify risk factors predictive of severe disease and death in France.MethodsIn this prospective cohort study, we included patients ≥ 18 years old with confirmed COVID-19, hospitalised in Strasbourg and Mulhouse hospitals (France), in March 2020. We respectively compared patients who developed severe disease (admission to an intensive care unit (ICU) or death) and pati ...[more]

PMID: 33272355

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Project description:AimsMitigation actions during the COVID-19 pandemic may impact mental health and suicide in general populations. We aimed to analyse the evolution in suicide deaths from 2020 to March 2022 in France.MethodsUsing free-text medical causes in death certificates, we built an algorithm, which aimed to identify suicide deaths. We measured its retrospective performances by comparing suicide deaths identified using the algorithm with deaths which had either a Tenth revision of the International Classification of Diseases (ICD-10) code for 'intentional self-harm' or for 'external cause of undetermined intent' as the underlying cause. The number of suicide deaths from January 2020 to March 2022 was then compared with the expected number estimated using a generalized additive model. The difference and the ratio between the observed and expected number of suicide deaths were calculated on the three lockdown periods and for periods between lockdowns and after the third one. The analysis was stratified by age group and gender.ResultsThe free-text algorithm demonstrated high performances. From January 2020 to mid-2021, suicide mortality declined during France's three lockdowns, particularly in men. During the periods between and after the two first lockdowns, suicide mortality remained comparable to the expected values, except for men over 85 years old and in 65-84 year-old age group, where a small number of excess deaths was observed in the weeks following the end of first lockdown, and for men aged 45-64 years old, where the decline continued after the second lockdown ended. After the third lockdown until March 2022, an increase in suicide mortality was observed in 18-24 year-old age group for both genders and in men aged 65-84 years old, while a decrease was observed in the 25-44 year-old age group.ConclusionsThis study highlighted the absence of an increase in suicide mortality during France's COVID-19 pandemic and a substantial decline during lockdown periods, something already observed in other countries. The increase in suicide mortality observed in 18-24 year-old age group and in men aged 65-84 years old from mid-2021 to March 2022 suggests a prolonged impact of COVID-19 on mental health, also described on self-harm hospitalizations and emergency department's attendances in France. Further studies are required to explain the factors for this change. Reactive monitoring of suicide mortality needs to be continued since mental health consequences and the increase in suicide mortality may be continued in the future with the international context.

Dataset Information

Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020.

Publications

Clinical characteristics and risk factors associated with severe COVID-19: prospective analysis of 1,045 hospitalised cases in North-Eastern France, March 2020.

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