Post by Nadica (She/Her) on Nov 30, 2024 6:13:40 GMT
Predictors of hospitalisation, death and incomplete/non-recovery from SARS-CoV-2 in an ambulatory global population - Published Nov 26, 2024
Highlights
• First prospective, global data for an ambulatory cohort in the COVID-19 pandemic
• Reports risk factors for progression and recovery during the first four waves
• Male sex, older age, comorbidities, pregnancy were risks for hospitalisation/death
• SARS-CoV-2 vaccination protected against progression
• Rates of progression and mortality declined significantly over time
Abstract
Objectives
To provide globally representative data on hospitalisation and death in recently SARS-CoV-2-positive ambulatory populations.
Methods
We enrolled SARS-CoV-2-positive ambulatory adults in the cohort studies, ICOS (47 sites, 5 continents), and PCOS (Liberia) and followed for 28-days. Kaplan-Meier estimates of percentage of those hospitalised or died were derived. Risk factors for hospitalisation, death, and failure to recover were identified using Cox and logistic models respectively.
Results
9817(ICOS) and 125(PCOS) participants, 46·7% male; median age 43 years; 24·5% with comorbidity(s); 0·8% pregnant; 9·3% SARS-CoV-2 vaccinated, were enrolled June-2020 and January-2022. By 28 days, 424(4·3%) participants were hospitalised or had died; most within 7 days of enrolment(3·4%). Hospitalisation or death declined over calendar time i.e. 7·5%(2020); 4·1(first-half 2021) and 2·1%(second-half 2021), P<0·0001. Older age, male sex, comorbidities, pregnancy, symptomatic disease were each independently associated with hospitalisation or death; SARS-CoV-2 vaccination reduced this risk. At 28 days, 26·1% and 29.9% reported ongoing symptoms and failure to return to pre-morbid health respectively.
Conclusions
These global SARS-CoV-2 ambulatory cohort studies identified demographic/clinical risks for hospitalisation or death. Vaccination does not fully explain hospitalisation and death declines over time. Symptomatic recovery and return to pre-morbid health were incomplete at 28 days in ≈one third.
Highlights
• First prospective, global data for an ambulatory cohort in the COVID-19 pandemic
• Reports risk factors for progression and recovery during the first four waves
• Male sex, older age, comorbidities, pregnancy were risks for hospitalisation/death
• SARS-CoV-2 vaccination protected against progression
• Rates of progression and mortality declined significantly over time
Abstract
Objectives
To provide globally representative data on hospitalisation and death in recently SARS-CoV-2-positive ambulatory populations.
Methods
We enrolled SARS-CoV-2-positive ambulatory adults in the cohort studies, ICOS (47 sites, 5 continents), and PCOS (Liberia) and followed for 28-days. Kaplan-Meier estimates of percentage of those hospitalised or died were derived. Risk factors for hospitalisation, death, and failure to recover were identified using Cox and logistic models respectively.
Results
9817(ICOS) and 125(PCOS) participants, 46·7% male; median age 43 years; 24·5% with comorbidity(s); 0·8% pregnant; 9·3% SARS-CoV-2 vaccinated, were enrolled June-2020 and January-2022. By 28 days, 424(4·3%) participants were hospitalised or had died; most within 7 days of enrolment(3·4%). Hospitalisation or death declined over calendar time i.e. 7·5%(2020); 4·1(first-half 2021) and 2·1%(second-half 2021), P<0·0001. Older age, male sex, comorbidities, pregnancy, symptomatic disease were each independently associated with hospitalisation or death; SARS-CoV-2 vaccination reduced this risk. At 28 days, 26·1% and 29.9% reported ongoing symptoms and failure to return to pre-morbid health respectively.
Conclusions
These global SARS-CoV-2 ambulatory cohort studies identified demographic/clinical risks for hospitalisation or death. Vaccination does not fully explain hospitalisation and death declines over time. Symptomatic recovery and return to pre-morbid health were incomplete at 28 days in ≈one third.