Hospital Mortality and Resource Implications of Hospitalisation with COVID-19 in London, UK: A Prospective Cohort Study

Table 3

Clinical findings and outcomes during hospital admission.

	Study population (n = 429)	Treated only on ward (n = 353)	Treated in ICU (n = 76)
Fever on ward^†	280/382 (72%)	252/349 (72%)	28/33 (82%)
Persistent hypoxia^‡	105/386 (27%)	74/353 (21%)	31/33 (94%)
Noninvasive respiratory support^§	17/386 (4%)	9/353 (2%)	8/33 (24%)
SBP <90 mmHg for >1 hour	40/386 (10%)	37/353 (10%)	3/33 (9%)
Heart rate >120/minute for >1 hour	43/386 (11%)	38/353 (11%)	5/33 (15%)
AVPU score V or below for >1 hour	22/386 (6%)	19/353 (5%)	3/33 (9%)
NEWS2 score >6^¶	195/378 (52%)	166/346 (48%)	31/32 (91%)
ICU outreach involvement	152/386 (39%)	87/353 (25%)	32/33 (97%)
COVID-19-specific drug treatment	7 (2%)	2/353 (1%)	5/76 (7%)
Subsequent chest X-ray	198 (46%)	124/353 (35%)	74/76 (97%)
No abnormal findings	21/198 (11%)	19/124 (15%)	2/74 (3%)
Diffuse opacities	128/177 (72%)	64/105 (61%)	64/72 (89%)
Bilateral opacities	141/177 (80%)	76/105 (72%)	65/72 (90%)
Pleural effusion	46/177 (26%)	34/105 (32%)	12/72 (17%)
Pneumothorax	3/177 (2%)	0 (0%)	3/72 (4%)
Chest CT	59 (14%)	29/353 (8%)	30/76 (39%)
Diffuse GGOs or consolidation	43/59 (73%)	15/29 (52%)	28/30 (93%)
Bilateral GGOs or consolidation	47/59 (80%)	19/29 (65%)	28/30 (93%)
Pulmonary embolism	15/59 (25%)	5/29 (17%)	10/30 (33%)
Organising pneumonia	8/59 (14%)	4/29 (14%)	4/30 (13%)
Fibrosis	7/59 (12%)	0 (0%)	7/30 (23%)
Echocardiogram	57 (13%)	22 (6%)	35/76 (46%)
LV ejection fraction <55%	10/57 (17%)	7/22 (32%)	3/35 (9%)
Regional wall motion abnormalities	3/57 (5%)	1/22 (4%)	2/35 (6%)
Pulmonary hypertension^††	13/57 (23%)	4/22 (18%)	9/35 (26%)
TAPSE <17 millimetres	2/57 (3%)	1/22 (4%)	1/35 (3%)
Pericardial effusion	4/57 (7%)	4/22 (18%)	0 (0%)
Vascular scan	23 (5%)	6 (2%)	17/76 (22%)
Deep vein thrombosis	5/23 (22%)	2/6 (33%)	3/17 (18%)
Positive respiratory sample^‡‡	46 (11%)	8 (2%)	38/76 (50%)
Gram-positive organism	4/42 (9%)	1/8 (12%)	3/38 (8%)
Gram-negative organism	32/46 (70%)	3/8 (37%)	29/38 (76%)
Viral	1/46 (2%)	1/8 (12%)	0 (0%)
Fungal	19/46 (41%)	3/8 (37%)	16/28 (42%)
Positive blood sample^‡‡	57 (13%)	26 (7%)	31/76 (41%)
Gram-positive organism	38/57 (67%)	19/26 (73%)	19/31 (61%)
Gram-negative organism	15/57 (26%)	7/26 (27%)	8/31 (26%)
Viral	13/57 (29%)	2/26 (8%)	11/31 (35%)
Fungal	5/57 (9%)	0 (0%)	5/31 (16%)
Treatment limitations on ward	236/386 (61%)	232/353 (66%)	4/33 (12%)
Treatment escalation plan	198/236 (84%)	196/232 (84%)	2/4 (50%)
Do-not-resuscitate order	203/236 (86%)	200/232 (86%)	3/4 (75%)
Time to institution of TEP or DNR, days	0 (0–1)	0 (0–1)	4 (0–13.5)
Deceased at hospital discharge, or at 30 days	112 (26%)	83 (23%)	29 (38%)
Hospital length of stay, days^§§	10 (4–22)	8 (4–18)	20 (12–35)
Among survivors	8 (4–20)	7 (4–15)	13 (9–16)
Among nonsurvivors	10 (4–24)	8 (4–20)	34 (16–38)

Data are reported as median (IQR) or n (%), or n/N (%) when some data are missing. Abbreviations: ICU, Intensive Care Unit; NEWS2, National Early Warning Score version 2; SBP, systolic blood pressure; F_iO₂, fraction of inspired oxygen; AVPU, “Alert, Verbal, Pain, Unresponsive” scale; COVID-19, coronavirus disease 19; CT, computed tomography; GGO, ground-glass opacities; LV, left ventricle; TAPSE, tricuspid annular plane systolic excursion. These results apply to 386 patients: all 353 ward patients and 33/76 (43%) ICU patients who were admitted to the ICU after being admitted to the ward for 12 hours or longer. ^†Defined as temperature of 38.0^oC (100.4^oF) or above. The temperature was missing in 4/386 patients (1%). ^‡Defined as oxygen requirement of more than 15 litres per minute (or F_iO₂ of 0.6 or above), for one hour or longer. ^§Defined as the need for high-flow nasal oxygen, continuous positive airway pressure (CPAP), or noninvasive ventilation (NIV), for one hour or longer. ^¶NEWS2 score was missing for 8/386 patients (2%). A NEWS2 score above 6 is considered a trigger for ICU outreach team assessment. COVID-19-specific drug treatment included the administration of one of the following medications specifically for the purpose of treating COVID-19: human IL-1 receptor antagonists, chloroquine, hydroxychloroquine, dexamethasone, interferon-beta, lopinavir-ritonavir, remdesivir, tocilizumab, and mesenchymal stem cell therapy. ^††Defined as estimated right ventricular systolic pressure above 35 mmHg or maximal tricuspid regurgitation velocity (TR V_max) above 2.8 metres per second. ^‡‡Numbers refer to patients, not samples. ^§§For inpatients at study onset, length of stay was calculated from the start of the follow-up period (February 25, 2020). Those who remained admitted to the hospital at the end of the follow-up period (April 30, 2020) were considered survivors, and length of stay was calculated until that date.