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Abstract
Background Descriptions of clinical characteristics of patients hospitalised withCOVID-19, their clinical course and short-term inpatient and outpatient outcomes in deprived urban populations in the UK are still relatively sparse. We describe the epidemiology, clinical course, experience of non-invasive ventilation and intensive care, mortality and short-term sequelae of patients admitted to two large District General Hospitals across a large East London National Health Service Trust during the first wave of the pandemic.
Methods A retrospective analysis was carried out on a cohort of 1946 patients with a clinical or laboratory diagnosis of COVID-19, including descriptive statistics and survival analysis. A more detailed analysis was undertaken of a subset of patients admitted across three respiratory units in the trust.
Results Increasing age, male sex and Asian ethnicity were associated with worse outcomes. Increasing severity of chest X-ray abnormalities trended with mortality. Radiological changes persisted in over 50% of cases at early follow-up (6 weeks). Ongoing symptoms including hair loss, memory impairment, breathlessness, cough and fatigue were reported in 70% of survivors, with 39% of patients unable to return to work due to ongoing symptoms.
Conclusions Understanding the acute clinical features, course of illness and outcomes of COVID-19 will be crucial in understanding the effect of differences in risk, as well as the effectiveness of new interventions and vaccination between the successive waves of the pandemic.
- clinical epidemiology
- imaging/CT MRI etc
- pneumonia
- respiratory infection
- viral infection
- non invasive ventilation
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Footnotes
Contributors All authors contributed to the study design and concept. DC, CC, ES and a wider team in the acknowledgements contributed to data extraction. Data analysis was performed by DC and CC. The manuscript was drafted, revised and reviewed by all authors.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The data collected during this study were reviewed by the Trust Research & Development and Clinical Audit department review panel and approval was granted without the need for ethical approval as per the NHS Health Research Authority and National Institute for Health Research guidance.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. Individual deidentified participant data (including data dictionaries) will be shared. Data that underlie the results reported in this article, after deidentification (text, tables, figures and appendices). Imaging data will not be available to view. Other documents which will be available include study protocol, statistical analysis plan, analytical code. Data will be available beginning from publication and ending five years following article publication. Data will be made available to all researchers who provide a methodologically sound proposal, for their stated aims. Proposals should be directed to daryl.cheng@nhs.net.
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